Sacral neuromodulation for faecal incontinence: is the outcome compromised in patients with high-grade internal rectal prolapse?

Abstract

The presence of a high-grade internal rectal prolapse has a detrimental effect on sacral neuromodulation for faecal incontinence.

Sacral nerve stimulation as a therapy for fecal incontinence

“…The board of experts also shares this view, but refers to a study by Prapasrivorakul et al [15]. In this study it was shown that patients with rectal intussusception (Oxford grade 3,4) exhibit a worse therapeutic outcome than patients without intussusception.…”

“…In patients with fecal incontinence and obstructed defecation syndrome, SNS is a good therapeutic option. Potential restrictions have been illustrated in question 27 [15].…”

Laparoscopic Ventral Rectopexy for Faecal Incontinence: Equivalent Benefit is seen in Internal and External Rectal Prolapse

“…24 Therefore, the question arises whether correction of the prolapse, e.g. by LVR might be considered as the treatment method for faecal incontinence in patients with high grade internal rectal prolapse with possible neurostimulation added later if the desired effect is not achieved.…”

Common Tests for the Pelvic Floor

“…The use of dynamic imaging in patients with pelvic fl oor prolapse may better identify patients requiring multi-compartment repair and prevent recurrences [ 136 , 137 ]. Given surgical correction of rectal intussusception (RI) can improve bowel continence [ 138 ], and the possibility that sacral neuromodulation may be less effective in treating fecal incontinence in patients with high grade RI [ 139 ], dynamic imaging is performed routinely in some centers in the evaluation of fecal incontinence.…”