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Sacral Nerve Stimulation for Fecal Incontinence Following Surgery for Rectal Prolapse Repair: A Multicenter Study

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

PURPOSE

A proportion of patients have fecal incontinence secondary to a full-thickness rectal prolapse that fails to resolve following prolapse repair. This multicenter, prospective study assessed the use of sacral nerve stimulation for this indication.

METHODS

Patients had to have more than or equal to four days with fecal incontinence per 21-day period more than one year after surgery. They had to have failed conservative treatment and have an intact external anal sphincter.

RESULTS

Four female patients aged 42, 54, 68, and 65 years met the inclusion criteria. Three of the four patients had had more than one operation for recurrent full-thickness rectal prolapse before sacral nerve stimulation, one of whom had undergone a further operation for recurrence following stimulation. One patient had undergone one operation for prolapse repair. The preoperative duration of symptoms was ten, eight, three, and nine years, respectively. Although patients had an intact external anal sphincter, one patient had a fragmented internal anal sphincter. The frequency of fecal incontinent episodes changed from 11, 24.7, 5, and 8 per week at baseline to 0, 1.5, 5.5, and 1 per week at latest follow-up. Ability to defer defecation was also improved in two of three patients who had this documented. Fecal incontinence–specific quality of life assessment showed an improvement in all four domains.

CONCLUSION

Sacral nerve stimulation should be considered for patients with ongoing fecal incontinence following full-thickness rectal prolapse repair if they prove resistant to conservative treatment.

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Author information

Authors and Affiliations

  1. Physiology Unit, St. Mark’s Hospital, London, England

    Michael E. D. Jarrett M.R.C.S. & Michael A. Kamm M.D.

  2. Department of General Surgery, University Hospital Erlangen, Erlangen, Germany

    Klaus E. Matzel Ph.D.

  3. Medtronic Europe Sarl, Tolochenaz, Switzerland

    Michael Stösser Ph.D.

  4. Department of General Surgery, Maastricht University Hospital, Maastricht, The Netherlands

    Cor G. M. I. Baeten Ph.D.

Authors
  1. Michael E. D. Jarrett M.R.C.S.
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  2. Klaus E. Matzel Ph.D.
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  3. Michael Stösser Ph.D.
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  4. Cor G. M. I. Baeten Ph.D.
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  5. Michael A. Kamm M.D.
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Corresponding author

Correspondence to Michael A. Kamm M.D..

Additional information

Supported by Medtronic Inc., Minneapolis, Minnesota.

The funding agent, Medtronic (Medtronic Bakken Research Center, Maastricht, The Netherlands), was involved in the study design and supported data collection and analysis. Interpretation of the data, writing of the manuscript, and decisions regarding submission were the responsibility of the writing committee.

Klaus E. Matzel and Michael E. D. Jarrett certify that they have no associations (e.g., commercial consultancies, stock ownership, equity interests, patent licensing arrangements, etc.) that might pose a conflict of interest in connection with this article.

Michael Kamm has been a consultant to Medtronic.

Michael Stösser is an employee of Medtronic and has a financial interest in the company.

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Jarrett, M., Matzel, K., Stösser, M. et al. Sacral Nerve Stimulation for Fecal Incontinence Following Surgery for Rectal Prolapse Repair: A Multicenter Study. Dis Colon Rectum 48, 1243–1248 (2005). https://doi.org/10.1007/s10350-004-0919-y

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  • DOI: https://doi.org/10.1007/s10350-004-0919-y

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