The effect of sacral nerve stimulation on distal colonic motility in patients with faecal incontinence

Abstract

SNS modulates colonic motility in patients with faecal urge incontinence. These data suggest that SNS may improve continence and urgency through alteration of colonic motility, particularly by increasing retrograde PSs in the left colon.

Gastric Electrical Stimulation and Sacral Electrical Stimulation: A Long-Term Follow up Study of Dual Device Treatment

“…Another study of eleven patients demonstrated an increase in retrograde colonic propagating sequences with SES. This suggests that the effect of SES may be primarily on colonic motility rather than directly affecting external anal sphincter and puborectalis function [16,17]. Further studies investigating upper GI symptoms following single-device SES may be undertaken to further support this hypothesis.…”

Evidence-Based Update on Treatments of Fecal Incontinence in Women

“…Proposed mechanisms of action include that SNS acts through a somatovisceral reflex pathway to reduce colonic activity, a direct effect on the anal sphincter complex to increase sphincter tone, reduce spontaneous sphincter relaxation, and change rectal sensitivity or compliance through afferent nerve modulation. [70-73] However, improvements in FI symptoms without changing sphincter pressures have also been reported. [70,74,75] Although data are limited, SNS has been shown effective in patients even with disrupted anal sphincters, including previously failed sphincteroplasty.…”

“…[70-73] However, improvements in FI symptoms without changing sphincter pressures have also been reported. [70,74,75] Although data are limited, SNS has been shown effective in patients even with disrupted anal sphincters, including previously failed sphincteroplasty. The extent of sphincter gap differs in existing data; up to 180° sphincter separation has been studied.…”

Management of Pelvic Floor Disorders: Biofeedback and More

“…This study was uncontrolled. The mechanisms by which SNS improves fecal incontinence are unknown because effects on anorectal functions are relatively minor [66]. SNS but not sham stimulation increased the frequency of retrograde propagated sequences throughout the colon.…”

“…SNS but not sham stimulation increased the frequency of retrograde propagated sequences throughout the colon. Similar to anti-diarrheal agents, these effects may delay colonic transit [66]. …”