Sacral Nerves - Sacral Nerve Stimulation For Treatment of Fecal Incontinence

Sacral Nerve Stimulation For Treatment of Fecal Incontinence

Fecal incontinence is the involuntary defecation and flatus release that afflict mainly elder people. The etiology is not well understood yet and both conservative (like antidiarrheics, special diet and biofeedback) and surgical treatments for this disorder are far from ideal option.

Pascual et al (2011) revised the follow up results of the first 50 people that submit to sacral nerve stimulation (SNS) to treat fecal incontinence in Madri (Spain). The most common cause for the fecal incontinence was obstetric procedures, idiopathic origin and prior anal surgery, and all these people were refractory to the conservative treatment. The procedure consisted of placing a temporary pulse generator connected to a unilateral electrode at S3 or S4 foramen for 2-4 weeks. After confirmed that the SNS was decreasing the incontinence episodes, the patients received the definitive electrode and pulse generator that was implanted in the gluteus or in the abdomen. Two patients did not show improvement in the first step and did not receive the definitive stimulator.

Mean follow up was 17.02 months and during this time the patients showed improvement in the voluntary contraction pressure and reduction of incontinence episodes. Complications were two cases of infection, two cases with pain and 1 broken electrode. Therefore, although the reason the SNS is effective is unknown, this procedure had satisfactory results in these clinical cases with a low incidence of complications and seems to be a good option of treatment of anal incontinence.

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