Systematic review of sacral nerve stimulation for faecal incontinence and constipation

Background and method: This systematic review assesses the efficacy and safety of sacral nerve stimulation (SNS) for faecal incontinence and constipation. Electronic databases and selected websites were searched for studies evaluating SNS in the treatment of faecal incontinence or constipation. Prim...

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Bibliographic Details
Published in:British journal of surgery 2004-12, Vol.91 (12), p.1559-1569
Main Authors: Jarrett, M. E. D., Mowatt, G., Glazener, C. M. A., Fraser, C., Nicholls, R. J., Grant, A. M., Kamm, M. A.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Constipation - therapy
Cross-Over Studies
Electric Stimulation Therapy - adverse effects
Electric Stimulation Therapy - methods
Fecal Incontinence - therapy
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Lumbosacral Plexus
Manometry
Medical sciences
Other diseases. Semiology
Quality of Life
Randomized Controlled Trials as Topic
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:Background and method: This systematic review assesses the efficacy and safety of sacral nerve stimulation (SNS) for faecal incontinence and constipation. Electronic databases and selected websites were searched for studies evaluating SNS in the treatment of faecal incontinence or constipation. Primary outcome measures included episodes of faecal incontinence per week (faecal incontinence studies) and number of evacuations per week (constipation studies). Results: From 106 potentially relevant reports, six patient series and one crossover study of SNS for faecal incontinence, and four patient series and one crossover study of SNS for constipation, were included. After implantation, 41–75 per cent of patients achieved complete faecal continence and 75–100 per cent experienced improvement in episodes of incontinence. There were 19 adverse events among 149 patients. The small crossover study reported increased episodes of faecal incontinence when the implanted pulse generator was switched off. Case series of SNS for constipation reported an increased frequency of evacuation. There were four adverse events among the 20 patients with a permanent implant. The small crossover study reported a reduced number of evacuations when the pulse generator was switched off. Conclusion: SNS results in significant improvement in faecal incontinence in patients resistant to conservative treatment. Early data also suggest benefit in the treatment of constipation. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Significant improvement in patients resistant to conservative treatment
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.4796