Sacral nerve stimulation for neurogenic faecal incontinence

Abstract

Abstract Background Sacral nerve stimulation (SNS) has emerged as a promising technique for the treatment of faecal incontinence. This study assessed the outcome of SNS in a cohort of patients with incontinence of neurological aetiology. Methods Thirty-six patients were included in a trial of SNS. Twenty-nine subsequently had a permanent implant. Evaluation consisted of a continence diary, anal manometry, saline retention testing and quality of life assessment. Results After a median follow-up of 35 (range 3–71) months, 28 patients showed a marked improvement in or complete recovery of continence. Incontinence to solid or liquid stool decreased from a median of 7 (range 4–15) to 2 (range 0–5) episodes in 21 days (P = 0·002). Saline retention time increased from a median of 2 (range 0–5) to 7 (range 2–15) min (P = 0·002). Maximum resting and squeeze anal canal pressures increased compared with preoperative values. Quality of life on all scales among patients who received a permanent implant increased at 12 and 24 months after operation. Conclusion SNS is of value in selected patients with neurogenic faecal incontinence.