Advertisement

Sacral Nerve Stimulation in Fecal Incontinence

  • Marileda IndinnimeoEmail author
  • Cosima Maria Moschella
  • Gloria Bernardi
  • Paolo Gozzo
Chapter

Abstract

Sacral nerve stimulation (SNS) has been used to treat urinary dysfunction by Tanagho EA and Schmidt RA since 1988. In 1995, Matzel et al. treated patients with functional bowel disorders with SNS, and this therapy was later proved to be also effective for fecal incontinence (FI) secondary to various functional or morphological causes, including large sphincter lesions (up to 180°). SNS delivers mild, non-painful, electrical pulses to the sacral nerves, ultimately improving or restoring function. Validated questionnaires should be administered to FI patients proposed for SNS, in order to assess the severity of FI and its impact on quality of life (QoL). Moreover, anorectal manometry, endoanal ultrasound, pelvic floor electromyography, pudendal nerve assessment, and also MRI should be performed, because every exam analyzes a specific aspect related to FI. Limited information is available to explain the mechanism of action of SNS, and the neurologic mechanism behind this procedure is still unclear. However, SNS is an easy surgical technique that can be performed under local anesthesia and totally reversible. InterStim® Therapy (Medtronic) is the only implantable system currently approved for SNS. As recommended by most of the authors, the optimal implantation site for the electrode is the third sacral foramen. SNS is usually performed with a two-stage procedure, where the first phase consists in a test stimulation period allowing the patient to evaluate the effectiveness of therapy, while at the second stage, the implantable pulse generator (IPG) is connected to the previously placed quadripolar wire. Device can be programmed in monopolar or bipolar configuration, with variable amplitude, frequency, and pulse width. The complications are sporadic and mainly consisting in sepsis and wire displacement. Patients are followed up regularly, 1 month, 6 months after the implant, and yearly thereafter. Long-term results are positive and prove SNS as significantly more effective than medical treatment on clinical outcomes and QoL. The cost of SNS, including diagnostic studies, implant, medication, and outpatient visits, amounts approximately to €14.973 per patient; however, the therapy is demonstrated to significantly reduce direct and indirect costs associated with FI, with respect to standard medical treatment.

Keywords

Fecal Incontinence Anal Sphincter External Anal Sphincter Pudendal Nerve Anal Incontinence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. NeurourolUrodyn. 2010;29(1):4–20.Google Scholar
  2. 2.
    Brown HW, Wexner SD, Segall MM, Brezoczky KL, Lukacz ES. Quality of life impact in women with accidental bowel leakage. Int J Clin Pract. 2012;66(11):1109–16.CrossRefPubMedGoogle Scholar
  3. 3.
    Manchio JV, Sanders BM. Fecal incontinence: help for patients who suffer silently. J Fam Pract. 2013;62(11):640–50.PubMedGoogle Scholar
  4. 4.
    Kang HW, Jung HK, Kwon KJ, et al. Prevalence and predictive factors of fecal incontinence. J Neurogastroenterol Motil. 2012;18(1):86–93.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Landefeld CS, Bowers BJ, Feld AD, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008;148(6):449–58.CrossRefPubMedGoogle Scholar
  6. 6.
    Saxtorph M. Stricture urethrae – Fistula perinee – Retentio urinae. Clinisk Chirurgi, Gyldendalske Forlag, Copenhagen. 1878:265–280.Google Scholar
  7. 7.
    Tanagho EA, Schmidt RA. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol. 1988;140:1331–4.PubMedGoogle Scholar
  8. 8.
    Matzel KE, Stadelmaier U, Hohenfeller M, Gall FP. Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet. 1995;346:1124–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Makol A, Grover M, Witehead WE. Fecal incontinence in women: causes and treatment. Womens Health. 2008;4(5):517–28.Google Scholar
  10. 10.
    Uludag O, Koch SM, van Gemert WG, Dejong CH, Baeten CG. Sacral neuromodulation in patients with fecal incontinence: a single-center study. Dis Colon Rectum. 2004;47(8):1350–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Altomare DF, Ratto C, Ganio E, Lolli P, Masin A, Villani RD. Long-term outcome of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum. 2009;52(1):11–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Melenhorst J, Koch SM, Uludag O, van Gemert WG, Baeten CG. Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantations. Colorectal Dis. 2007;9(8):725–30.CrossRefPubMedGoogle Scholar
  13. 13.
    Michelsen HB, Thompson-Fawcett M, Lundby L, Krogh K, Laurberg S, Buntzen S. Six years of experience with sacral nerve stimulation for fecal incontinence. Dis Colon Rectum. 2010;53(4):414–21.CrossRefPubMedGoogle Scholar
  14. 14.
    Hull T, Giese C, Wexner SD, Mellgren A, Devroede G, Madoff RD, et al. Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum. 2013;56(2):234–45.CrossRefPubMedGoogle Scholar
  15. 15.
    Brazzelli M, Murray A, Fraser C. Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: a systematic review. J Urol. 2006;175:835–41.CrossRefPubMedGoogle Scholar
  16. 16.
    Gajewski JB, Al-Zahrani AA. The long-term efficacy of sacral neuromodulation in the management of intractable cases of bladder pain syndrome: 14 years of experience in one centre. BJU Int. 2011;107:1258–64.CrossRefPubMedGoogle Scholar
  17. 17.
    Herbison GP, Arnold EP. Sacral neuromodulation with implanted devices for urinary storage and voiding dysfunction in adults. Cochrane database Syst Rev. 2009;(2):CD004202.Google Scholar
  18. 18.
    Wang JY, Abbas MA. Current management of fecal incontinence. Perm J. 2013;17(3):65–73.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Fisher K, Bliss DZ, Savik K. Comparison of recall and daily self-report of fecal incontinence severity. J Wound Ostomy Continence Nurs. 2008;35(5):515–20.CrossRefPubMedGoogle Scholar
  20. 20.
    Alas AN, Bergman J, Dunivan GC, et al. Readability of common health-related quality-of-life instruments in female pelvic medicine. Female Pelvic Med Reconstr Surg. 2013;19(5):293–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Wiebe S, Guyatt G, Weaver B, Matijevic S, Sidwell C. Comparative responsiveness of generic and specific quality-of-life instruments. J Clin Epidemiol. 2003;56(1):52–60.CrossRefPubMedGoogle Scholar
  22. 22.
    Meyer I, Richter IE. Impact of fecal incontinence and its treatment on quality of life in women. Womens Health. 2015;11(2):225–38.Google Scholar
  23. 23.
    Abrams P, Andersson KE, Birder L, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. NeurourolUrodyn. 2010;29(1):213–40.Google Scholar
  24. 24.
    Cotterill N, Norton C, Avery KN, Abrams P, Donovan JL. A patient-centered approach to developing a comprehensive symptom and quality of life assessment of anal incontinence. Dis Colon Rectum. 2008;51(1):82–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Cotterill N, Norton C, Avery KN, Abrams P, Donovan JL. Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life: the ICIQ-B. Dis Colon Rectum. 2011;54(10):1235–50.CrossRefPubMedGoogle Scholar
  26. 26.
    Smith TM, Menees SB, Xu X, Saad RJ, Chey WD, Fenner DE. Factors associated with quality of life among women with fecal incontinence. Int Urogynecol J. 2013;24(3):493–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Markland AD, Greer WJ, Vogt A, et al. Factors impacting quality of life in women with fecal incontinence. Dis Colon Rectum. 2010;53(8):1148–54.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Rockwood TH, Church JM, Fleshman JW, et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum. 1999;42(12):1525–32.CrossRefPubMedGoogle Scholar
  29. 29.
    Bartlett L, Nowak M, Ho YH. Impact of fecal incontinence on quality of life. World J Gastroenterol. 2009;15(26):3276–82.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Bordeianou L, Rockwood T, Baxter N, Lowry A, Mellgren A, Parker S. Does incontinence severity correlate with quality of life? Prospective analysis of 502 consecutive patients. Colorectal Dis. 2008;10(3):273–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Glasgow SC, Lowry AC. Long-term outcomes of anal sphincter repair for fecal incontinence: a systematic review. Dis Colon Rectum. 2012;55(4):482–90.CrossRefPubMedGoogle Scholar
  32. 32.
    Costilla VC, Foxx-Orenstein AE, Mayer AP, et al. Office-based management of fecal incontinence. Gastroenterol Hepatol. 2013;9(7):423–33.Google Scholar
  33. 33.
    Rao SSC, American College of Gastroenterology Practice Parameters Committee. Diagnosis and management of fecal incontinence. Am J Gastroenterol. 2004;99:1585–604.CrossRefPubMedGoogle Scholar
  34. 34.
    Coller JA. Clinical application of anorectal manometry. Gastroenterol Clin North Am. 1987;16:17.PubMedGoogle Scholar
  35. 35.
    Orkin BA, Sinykin SB, Lloyd PC. The digital rectal examination scoring system (DRESS). Dis Colon Rectum. 2010;53:1656.CrossRefPubMedGoogle Scholar
  36. 36.
    Felt-Bersma RJ, Klinkenberg-Knol EC, Meuwissen SGM. Investigation of anorectal function. Br J Surg. 1988;75:53–5.CrossRefPubMedGoogle Scholar
  37. 37.
    Eckhardt VF, Kanzler G. How reliable is digital examination for the evaluation of anal sphincter tone? Int J Colorectal Dis. 1993;8:95–7.CrossRefGoogle Scholar
  38. 38.
    Hill J, Corson RJ, Brandon H, et al. History and examination in the assessment of patients with idiopathic fecal incontinence. Dis Colon Rectum. 1994;37(5):473–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Rao SSC. Advances in diagnostic assessment of fecal incontinence and dyssynergic defecation. Gastroenterol Hepatol. 2008;2:323–5.Google Scholar
  40. 40.
    Remes-Troche JM, Rao SSC. Neurophysiological testing in anorectal disorders. Gastroenterol Hepatol. 2008;2:323–35.Google Scholar
  41. 41.
    Gurland B, Hull T. Transrectal ultrasound, manometry, and pudendal nerve terminal latency studies in the evaluation of sphincter injuries. Clin Colon Rectal Surg. 2008;21(3):157–66.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Law PJ, Kamm MA, Bartram CI. Anal endosonography in the investigation of faecal incontinence. Br J Surg. 1991;78:312–4.CrossRefPubMedGoogle Scholar
  43. 43.
    Bartrum C. Rao SCC. Disorders of anorectum. Gastroenterol Clin North Am. W.B. Saunders. 1. Vol. 30. 2001. Radiological evaluation of anorectal disorders; p. 55–76.Google Scholar
  44. 44.
    Dobben AC, Terra MP, Deutekom M, et al. Anal inspection and digital rectal examination compared to anorectal physiology tests and endoanal ultrasonography in evaluating fecal incontinence. Int J Colorectal Dis. 2007;22(7):783–90.CrossRefPubMedGoogle Scholar
  45. 45.
    Abdool Z, Sultan AH, Thakar R. Ultrasound imaging of the anal sphincter complex: a review. Br J Radiol. 2012;85(1015):865–75.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Jones MP, Post J, Crowell MD. High-resolution manometry in the evaluation of anorectal disorders: a simultaneous comparison with water-perfused manometry. Am J Gastroenterol. 2007;102:850–5.CrossRefPubMedGoogle Scholar
  47. 47.
    Barnett JL, Hasler WL, Camilleri M. American Gastroenterological Association medical position statement on anorectal testing techniques. American Gastroenterological Association. Gastroenterology. 1999;116:732.CrossRefPubMedGoogle Scholar
  48. 48.
    Remes-Troche JM, Paulson J, Attaluri A, et al. A comprehensive assessment of the efferent motor pathways to the anorectum in humans. Neuorgastroenterol Motil. 2007;19:330.Google Scholar
  49. 49.
    Hayden DM, Weiss EG. Fecal incontinence: etiology, evaluation, and treatment. Clin Colon Rectal Surg. 2011;24(1):64–70.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Hobson AR, Aziz Q. Brain imaging and functional gastrointestinal disorders: has it helped our understanding? Gut. 2004;53:1198–206.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Hobday DI, Hobson AR, Sarkar S, et al. Cortical processing of human gut sensation: an evoked potential study. Am J Physiol Gastrointest Liver Physiol. 2002;283:335–9.CrossRefGoogle Scholar
  52. 52.
    Chan YK, Herkes GK, Badcock C, et al. Alterations in cerebral potentials evoked by rectal distension in irritable bowel syndrome. Am J Gastroenterol. 2001;96:2413–7.CrossRefPubMedGoogle Scholar
  53. 53.
    Sinhamahaptra P, Saha SP, Chowdhury A, et al. Visceral afferent hypersensitivity in irritable bowel syndrome – evaluation by cerebral evoked potential after rectal stimulation. Am J Gastroenterol. 2001;96:2150–7.Google Scholar
  54. 54.
    Person B, Wexner SD. Advances in the surgical treatment of faecal incontinence. Surg Innovation. 2005;12(1):7–21.CrossRefGoogle Scholar
  55. 55.
    Barber MD, Bremer RE, Thor KB, Dolber PC, Kuehl TJ, Coates KW. Innervation of the female levator ani muscles. Am J Obstet Gynecol. 2002;187(1):64–71.CrossRefPubMedGoogle Scholar
  56. 56.
    Grigorescu BA, Lazarou G, Olson T, Downie SA, Powers K, Greston WM, Mikhail MS. Innervation of the levator ani muscles: description of the nerve branches to the pubococcygeus, iliococcygeus, and puborectalis muscles. Int Urogynecol J. 2008;19:107–16.CrossRefGoogle Scholar
  57. 57.
    Chan CLH, Ponsford S, Scott SM, Swash M, Lunniss PJ. Contribution of the pudendal nerve to sensation of the distal rectum. Br J Surg. 2005;92:859–65.CrossRefPubMedGoogle Scholar
  58. 58.
    Matzel KE, Schmidt RA, Tanagho EA. Neuroanatomy of the striated muscular anal continence mechanism. Dis Colon Rectum. 1990;33(8):666–73.CrossRefPubMedGoogle Scholar
  59. 59.
    Fowler CJ, Swinn MJ, Goodwin RJ, Oliver S, Craggs M. Studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated. J Urol. 2000;163:881–3.CrossRefPubMedGoogle Scholar
  60. 60.
    Chancellor MB, Chartier-Kastler EJ. Principles of Sacral Nerve Stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromodulation J Int Neuromodulation Soc. 2000;3:16–26.CrossRefGoogle Scholar
  61. 61.
    Blok BF, Groen J, Bosch JL, Veltman DJ, Lammertsma AA. Different brain effects during chronic and acute sacral neuromodulation in urge incontinent patients with implanted neurostimulators. BJU Int. 2006;98:1238–43.CrossRefPubMedGoogle Scholar
  62. 62.
    Abdel-Halim MR, Crosbie J, Engledow A, Windsor A, Cohen CR, Emmanuel AV. Temporary sacral nerve stimulation alters rectal sensory function: a physiological study. Dis Colon Rectum. 2011;54:1134–40.CrossRefPubMedGoogle Scholar
  63. 63.
    Gourcerol G, Vitton V, Leroi AM, Michot F, Abysique A, Bouvier M. How sacral nerve stimulation works in patients with faecal incontinence. Colorectal Dis Off J Assoc Coloproctol Great Britain Ireland. 2011;13:e203–11.CrossRefGoogle Scholar
  64. 64.
    Dinning PG, Fuentealba SE, Kennedy ML, Lubowski DZ, Cook IJ. Sacral nerve stimulation induces pan-colonic propagating pressure waves and increases defecation frequency in patients with slow-transit constipation. Colorectal Dis Off J Assoc Coloproctol Great Britain Ireland. 2007;9:123–32.CrossRefGoogle Scholar
  65. 65.
    Dinning PG, Hunt LM, Arkwright JW, Patton V, Szczesniak MM, Wiklendt L, Davidson JB, Lubowski DZ, Cook IJ. Pancolonic motor response to subsensory and suprasensory sacral nerve stimulation in patients with slow-transit constipation. Br J Surg. 2012;99:1002–10.CrossRefPubMedGoogle Scholar
  66. 66.
    Leroi AM, Damon H, Faucheron JL, Lehur PA, Siproudhis L, Slim K, Barbieux JP, Barth X, Borie F, Bresler L, Desfourneaux V, Goudet P, Huten N, Lebreton G, Mathieu P, Meurette G, Mathonnet M, Mion F, Orsoni P, Parc Y, Portier G, Rullier E, Sielezneff I, Zerbib F, Michot F, Club NEMO. Sacral nerve stimulation in faecal incontinence: position statement based on a collective experience. Colorectal Dis. 2009;11(6):572–83.CrossRefPubMedGoogle Scholar
  67. 67.
    Falletto E, Ganio E, Naldini G, Ratto C, Altomare DF. Sacral neuromodulation for bowel dysfunction: a consensus statement from the Italian group. Tech Coloproctol. 2014;18(1):53–64.CrossRefPubMedGoogle Scholar
  68. 68.
    Benson JT. Sacral nerve stimulation results may be improved by electrodiagnostic techniques. Int Urogynecol Pelvic Floor Dysfunct. 2000;11:352–7.CrossRefGoogle Scholar
  69. 69.
    Spinelli M, Giardiello G, Arduini A, van den Hombergh U. New percutaneous technique of sacral nerve stimulation has high initial success rate: preliminary results. Eur Urol. 2003;43:70–4.CrossRefPubMedGoogle Scholar
  70. 70.
    Spinelli M, Giardiello G, Gerber M, Arduini A, van den Hombergh U, Malaguti S. New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience. J Urol. 2003;170:1905–7.CrossRefPubMedGoogle Scholar
  71. 71.
    Chatoor D, Emmanuel A. Constipation and evacuation disorders. Best Pract Res Clin Gastroenterol. 2009;23:517–30.CrossRefPubMedGoogle Scholar
  72. 72.
    Borawski KM, Foster RT, Webster GD, Amundsen CL. Predicting implantation with a neuromodulator using two different test stimulation techniques: a prospective randomized study in urge incontinent women. Neurourol Urodyn. 2007;26(1):14–8.CrossRefPubMedGoogle Scholar
  73. 73.
    Cohen BL, Tunuguntla HS, Gousse A. Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol. 2006;175:2178–80; discussion 2180–81.CrossRefPubMedGoogle Scholar
  74. 74.
    Govaert B, Melenhorst J, van Gemert WG, Baeten CG. Can sensory and/or motor reactions during percutaneous nerve evaluation predict outcome of sacral nerve modulation? Dis Colon Rectum. 2009;52:1423–6.CrossRefPubMedGoogle Scholar
  75. 75.
    Altomare DF, Rinaldi M, Lobascio P, Marino F, Giuliani RT, Cuccia F. Factors affecting the outcome of temporary sacral nerve stimulation for faecal incontinence. The value of the new tined lead electrode. Colorectal Dis. 2011;13(2):198–202.CrossRefPubMedGoogle Scholar
  76. 76.
    Jacobs SLF, Noblett KL. Randomized prospective cross-over study of Interstim lead wire placement with curved vs. straight stylet [abstract]. Female Pelvic Med Reconstr Surg. 2012;18:S52–3.Google Scholar
  77. 77.
    Marcelissen TA, Leong RK, Serroyen J, van Kerrebroeck PE, De Wachter SG. The use of bilateral sacral nerve stimulation in patients with loss of unilateral treatment efficacy. J Urol. 2011;185(3):976–80.CrossRefPubMedGoogle Scholar
  78. 78.
    Scheepens WA, de Bie RA, Weil EH, van Kerrebroeck PE. Unilateral versus bilateral sacral neuromodulation in patients with chronic voiding dysfunction. J Urol. 2002;168(5):2046–50.CrossRefPubMedGoogle Scholar
  79. 79.
    Mellgren A, Wexner SD, Coller JA, Devroede G, Lerew DR, Madoff RD, Hull T. Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum. 2011;54:1065–75.CrossRefPubMedGoogle Scholar
  80. 80.
    Maeda Y, Matzel K, Lundby L, Buntzen S, Laurberg S. Postoperative issues of sacral nerve stimulation for fecal incontinence and constipation: a systematic literature review and treatment guideline. Dis Colon Rectum. 2011;54:1443–60.CrossRefPubMedGoogle Scholar
  81. 81.
    Duelund-Jacobsen J, Lehur PA, Lundby L, Wyart V, Laurberg S, Buntzen S. Sacral nerve stimulation for faecal incontinence – efficacy confirmed from a two-centre prospectively maintained database. Int J Colorectal Dis. 2016;31:421–8.CrossRefGoogle Scholar
  82. 82.
    Tan E, Ngo NT, Darzi A, Shenouda M, Tekkis PP. Meta-analysis: sacral nerve stimulation versus conservative therapy in the treatment of faecal incontinence. Int J Colorectal Dis. 2011;26:275–94.CrossRefPubMedGoogle Scholar
  83. 83.
    Hollingshead JR, Dudding TC, Vaizey CJ. Sacral nerve stimulation for faecal incontinence: results from a single centre over a 10-year period. Colorectal Dis. 2011;13:1030–4.CrossRefPubMedGoogle Scholar
  84. 84.
    George AT, Kalmar K, Panarese A, Dudding TC, Nicholls RJ, Vaizey CJ. Long-term outcomes of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum. 2012;55:302–6.CrossRefPubMedGoogle Scholar
  85. 85.
    Lim JT, Hastie IA, Hiscock RJ, Shedda SM. Sacral nerve stimulation for fecal incontinence: long-term outcomes. Dis Colon Rectum. 2011;54:969–74.CrossRefPubMedGoogle Scholar
  86. 86.
    Wexner SD, Coller JA, Devroede G, Hull T, McCallum R, Chan M, Ayscue JM, Shobeiri AS, Margolin D, England M, et al. Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study. Ann Surg. 2010;251:441–9.CrossRefPubMedGoogle Scholar
  87. 87.
    Damon H, Barth X, Roman S, Mion F. Sacral nerve stimulation for fecal incontinence improves symptoms, quality of life and patients’ satisfaction: results of a monocentric series of 119 patients. Int J Colorectal Dis. 2013;28:227–33.CrossRefPubMedGoogle Scholar
  88. 88.
    Devroede G, Giese C, Wexner SD, Mellgren A, Coller JA, Madoff RD, Hull T, Stromberg K, Iyer S. Quality of life is markedly improved in patients with fecal incontinence after sacral nerve stimulation. Female Pelvic Med Reconstr Surg. 2012;18:103–12.CrossRefPubMedGoogle Scholar
  89. 89.
    Duelund-Jakobsen J, van Wunnik B, Buntzen S, Lundby L, Baeten C, Laurberg S. Functional results and patient satisfaction with sacral nerve stimulation for idiopathic faecal incontinence. Colorectal Dis. 2012;14:753–9.CrossRefPubMedGoogle Scholar
  90. 90.
    Jadav AM, Wadhawan H, Jones GL, Wheldon LW, Radley SC, Brown SR. Does sacral nerve stimulation improve global pelvic function in women? Colorectal Dis. 2013;15:848–57.CrossRefPubMedGoogle Scholar
  91. 91.
    Leroi AM, Parc Y, Lehur PA, Mion F, Barth X, Rullier E, Bresler L, Portier G, Michot F. Efficacy of sacral nerve stimulation for fecal incontinence: results of a multicenter double-blind crossover study. Ann Surg. 2005;242:662–9.CrossRefPubMedPubMedCentralGoogle Scholar
  92. 92.
    Boyle DJ, Knowles CH, Lunniss PJ, Scott SM, Williams NS, Gill KA. Efficacy of sacral nerve stimulation for fecal incontinence in patients with anal sphincter defects. Dis Colon Rectum. 2009;52:1234–9.CrossRefPubMedGoogle Scholar
  93. 93.
    Brouwer R, Duthie G. Sacral nerve neuromodulation is effective treatment for fecal incontinence in the presence of a sphincter defect, pudendal neuropathy, or previous sphincter repair. Dis Colon Rectum. 2010;53:273–8.CrossRefPubMedGoogle Scholar
  94. 94.
    Koughnett JA, Wexner SD. Current management of fecal incontinence: choosing amongst treatment options to optimize outcomes. World J Gastroenterol. 2013;19(48):9216–30.CrossRefPubMedPubMedCentralGoogle Scholar
  95. 95.
    Drossman DA, Li Z, Andruzzi E. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993;38(9):1569–80.CrossRefPubMedGoogle Scholar
  96. 96.
    Xu X, Menees SB, Zochowski MK, Fenner DE. Economic cost of fecal incontinence. Dis Colon Rectum. 2012;55(5):586–98.CrossRefPubMedGoogle Scholar
  97. 97.
    Deutekom M, Dobben AC, Dijkgraaf MG, Terra MP, Stoker J, Bossuyt PM. Costs of outpatients with fecal incontinence. Scand J Gastroenterol. 2005;40(5):552–8.CrossRefPubMedGoogle Scholar
  98. 98.
    Leroi AM, Lenne X, Dervaux B, Chartier-Kastler E, Mauroy B, Normand LL, Grise P, Faucheron JL, Parc Y, Lehur PA, et al. Outcome and cost analysis of sacral nerve modulation for treating urinary and/or fecal incontinence. Ann Surg. 2011;253:720–32.CrossRefPubMedGoogle Scholar
  99. 99.
    Hetzer FH, Bieler A, Hahnloser D, et al. Outcome and cost analysis of sacral nerve stimulation for faecal incontinence. Br J Surg. 2006;93:1411–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Marileda Indinnimeo
    • 1
    Email author
  • Cosima Maria Moschella
    • 1
  • Gloria Bernardi
    • 1
  • Paolo Gozzo
    • 1
  1. 1.Department of Surgery “P. Valdoni”Sapienza – University of RomeRomeItaly

Personalised recommendations