Sacral nerve stimulation for faecal incontinence: results from a single centre over a 10-year period

Colorectal Dis. 2011 Sep;13(9):1030-4. doi: 10.1111/j.1463-1318.2010.02383.x.

Abstract

Aim: Sacral nerve stimulation (SNS) is considered a first-line surgical treatment option for faecal incontinence. There is little information on long-term results. The results of SNS for faecal incontinence performed at a single centre over a 10-year period are reported.

Method: A cohort analysis of consecutive patients treated with SNS for faecal incontinence over a 10-year period was carried out. Data were collected prospectively using bowel habit diaries and St Mark's and Cleveland Clinic incontinence scores. Treatment success was defined as a >50% reduction in episodes of faecal incontinence compared with baseline.

Results: Temporary SNS was performed in 118 patients, and 91 (77%) were considered suitable for chronic stimulation. The median period of follow up was 22 (1-138) months. Seventy patients were followed for 1 year with success in 63 (90%). Of 18 patients followed for 5 years, 15 (83%) reported continued success, 11 (61%) maintained full efficacy, 4 (22%) reported some loss, and 3 (17%) reported complete loss. Three patients with a 10-year follow up had no loss in efficacy. Overall, complete loss of efficacy was observed in 14 (16%) patients at a median of 11.5 months following implantation. A further 5 (6%) patients showed deterioration with time. In 9 (47%), no reason for the deterioration in symptoms could be identified.

Conclusions: SNS can be effective for up to 10 years. Some patients experience deterioration in symptoms over time. The reasons for this are often not evident.

MeSH terms

  • Anal Canal / innervation*
  • Anal Canal / physiopathology
  • Cohort Studies
  • Electric Stimulation Therapy*
  • Fecal Incontinence / physiopathology
  • Fecal Incontinence / therapy*
  • Follow-Up Studies
  • Humans
  • Lumbosacral Plexus
  • Time Factors
  • Treatment Outcome