Sacral nerve stimulation for faecal incontinence: medium‐term follow‐up from a single institution

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Faecal incontinence occurs more commonly than previously appreciated1 and accounts for substantial social and economic costs.3 The aetiology of incontinence is multifactorial with obstetric injury, levator muscle trauma6 and anorectal surgery being important risk factors.
Non‐surgical treatment options are often ineffective, especially in subjects with severe faecal incontinence.7 Sphincter repair has short‐term good results but efficacy diminishes over time11 and to some extent the same is true for postanal repair.12 Sphincter augmentation procedures such as stimulated graciloplasty or artificial bowel sphincter may be effective but are associated with significant morbidity.14
Sacral nerve stimulation (SNS) has redefined the treatment algorithm for faecal incontinence.16 One attraction of the procedure is the ability to do a temporary trial of nerve stimulation (peripheral nerve evaluation, PNE) to assess whether long‐term stimulation is likely to be successful, with 65–90% of PNE cases showing improvement and progressing to a permanent stimulator.21 Successful cases include patients with neurogenic incontinence and also patients with a sphincter defect of up to 180° on ultrasound.24
There are few published Australian studies demonstrating the efficacy of SNS. The aims of this study were to evaluate medium‐term continence and quality of life after SNS in a large study from a single centre in Australia.
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