Techniques in Coloproctology

, Volume 17, Issue 5, pp 589–592

Sacral nerve stimulation (SNS), posterior tibial nerve stimulation (PTNS) or acupuncture for the treatment for fecal incontinence: a clinical commentary


    • Department of SurgerySahlgrenska University Hospital
  • U. Angerås
    • Department of SurgerySahlgrenska University Hospital
  • M. Scaglia
    • Department of SurgeryS. Luigi Gonzaga University Hospital
  • D. Delbro
    • School of Health and Medical SciencesÖrebro University
Controversies in Colorectal Surgery

DOI: 10.1007/s10151-013-0985-z

Cite this article as:
Hultén, L., Angerås, U., Scaglia, M. et al. Tech Coloproctol (2013) 17: 589. doi:10.1007/s10151-013-0985-z


Sacral nerve stimulation (SNS) has become an established therapy worldwide for the treatment for fecal incontinence. A large number of papers have been published over the years, and SNS is generally considered very effective with improved continence and quality of life for most patients. However, the results are mostly expressed in the semi-quantitative terms, that is, patients’ diaries translated into score points. The clinical value of SNS is questionable, especially as the patient groups are usually small and/or etiologically heterogenic and the follow-up period mostly short. The Health Technology Assessment organization in the west region of Sweden has recently evaluated the SNS with regard to evidence, efficacy and risks. Economic and ethical aspects raise serious questions on this expensive and not entirely risk-free treatment in routine medical care. Similar criticism has also been raised by other reviewers proposing a more thorough scientific assessment with well-designed randomized trials and comparison with other similar methods of treatment.


Fecal incontinenceSacral nerve stimulationPosterior tibial nerve stimulationAcupuncture

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© Springer-Verlag Italia 2013