Abstract
Sacral nerve stimulation is an innovative, mininvasive approach to fecal incontinence and other pelvic floor dysfunctions based on the delivery of electrical stimuli to the pelvic nerves through an electrode percutaneously positioned through the sacral foramen (usually S3) and connected to an implantable pulse generator. This technique has the unique advantages to affect continence without performing operations on the anal sphincter and to have the possibility to pretesting the outcome of the definitive implant with a low-cost temporary stimulation. Its reliability and effectiveness is nowadays recognized by the FDA [1], by the NICE [2], and by the main Coloproctological scientific societies (ASCRS, ESCP, ICS) and systematic reviews [3].
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References
Mellgren A, Wexner SD, Coller JA et al (2011) Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 54:1065–1075
Norton C, Thomas L, Hill J (2007) Guideline Development Group. Management of faecal incontinence in adults: summary of NICE guidance. BMJ 334:1370–1371
Thin NN, Horrocks EJ, Hotouras A et al (2013) Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence. Br J Surg 100:1430–1447
Lucas MG, Bosch RJ, Burkhard FC et al (2013) EAU guidelines on surgical treatment of urinary incontinence. Actas Urol Esp 37:459–472
Matzel KE, Stadelmaier U, Hohenfellner M et al (1995) Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet 346:1124–1127
Matzel KE, Kamm MA, Stösser M et al (2004) Sacral spinal nerve stimulation for faecal incontinence: multicentre study. Lancet 363:1270–1276
Malouf AJ, Vaizey CJ, Nicholls RJ et al (2000) Permanent sacral nerve stimulation for fecal incontinence. Ann Surg 232:143–148
Jarrett ME, Matzel KE, Stösser M et al (2005) Sacral nerve stimulation for faecal incontinence following a rectosigmoid resection for colorectal cancer. Int J Colorectal Dis 20:446–451
Ratto C, Grillo E, Parello A et al (2005) Sacral neuromodulation in treatment of fecal incontinence following anterior resection and chemoradiation for rectal cancer. Dis Colon Rectum 48:1027–1036
Ratto C, Litta F, Parello A et al (2012) Sacral nerve stimulation in faecal incontinence associated with an anal sphincter lesion: a systematic review. Colorectal Dis 14:e297–e304. doi:10.1111/j.1463-1318.2012.03003.x
Brindley GS (1993) History of the sacral anterior root stimulator, 1969–1982. Neurourol Urodyn 12:481–483
Tanagho EA, Schmidt RA, Orvis BR (1989) Neural stimulation for control of voiding dysfunction: a preliminary report in 22 patients with serious neuropathic voiding disorders. J Urol 142(2 Pt 1):340–345
Spinelli M, Giardiello G, Gerber M et al (2003) New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience. J Urol 170:1905–1907
Kessler TM, Madersbacher H, Kiss G (2005) Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method? Eur Urol 47:660–665
Dudding TC, Vaizey CJ, Gibbs A et al (2009) Improving the efficacy of sacral nerve stimulation for faecal incontinence by alteration of stimulation parameters. Br J Surg 96:778–784. doi:10.1002/bjs.6637
Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97
Vaizey CJ, Carapeti E, Cahill JA et al (1999) Prospective comparison of faecal incontinence grading systems. Gut 44:77–80
Sansoni J, Hawthorne G, Fleming G et al (2013) The revised faecal incontinence scale: a clinical validation of a new, short measure for assessment and outcomes evaluation. Dis Colon Rectum 56:652–659. doi:10.1097/DCR.0b013e318279c2ac
Rockwood TH, Church JM, Fleshman JW et al (2000) Fecal incontinence quality of life scale. Quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 43:9–17
Cotterill N, Norton C, Avery KN et al (2011) 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 54:1235–1250
Melenhorst J, Koch SM, Uludag O et al (2007) Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantations. Colorectal Dis 9:725–730
Altomare DF, Rinaldi M, Lobascio P et al (2011) Factors affecting the outcome of temporary sacral nerve stimulation for faecal incontinence. The value of the new tined lead electrode. Colorectal Dis 13:198–202
Maeda Y, Norton C, Lundby L et al (2010) Predictors of the outcome of percutaneous nerve evaluation for faecal incontinence. Br J Surg 97:1096–1102
Moya P, Arroyo A, Lacueva J et al (2014) Sacral nerve stimulation in the treatment of severe faecal incontinence: long-term clinical, manometric and quality of life results. Tech Coloproctol 18:179–185
Fowler CJ, Swinn MJ, Goodwin RJ et al (2000) Studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated. J Urol 163:881–883
Roman S, Tatagiba T, Damon H et al (2008) Sacral nerve stimulation and rectal function: results of a prospective study in faecal incontinence. Neurogastroenterol Motil 20:1127–1131
Griffiths D, Tadic SD (2008) Bladder control, urgency, and urge incontinence: evidence from functional brain imaging. Neurourol Urodyn 27:466–474
Giani I, Novelli E, Martina S et al (2011) The effect of sacral nerve modulation on cerebral evoked potential latency in fecal incontinence and constipation. Ann Surg 254:90–96
Lundby L, Møller A, Buntzen S et al (2011) Relief of fecal incontinence by sacral nerve stimulation linked to focal brain activation. Dis Colon Rectum 54:318–323
Altomare DF, Giannini I, Giuratrabocchetta S et al (2013) The effects of sacral nerve stimulation on continence are temporarily maintained after turning the stimulator off. Colorectal Dis 15:e741–e748
Ganio E, Masin A, Ratto C et al (2001) Short-term sacral nerve stimulation for functional anorectal and urinary disturbances: results in 40 patients: evaluation of a new option for anorectal functional disorders. Dis Colon Rectum 44:1261–1267
Vaizey CJ, Kamm MA, Turner IC et al (1999) Effects of short term sacral nerve stimulation on anal and rectal function in patients with anal incontinence. Gut 44:407–412
Rosen HR, Urbarz C, Holzer B et al (2001) Sacral nerve stimulation as a treatment for fecal incontinence. Gastroenterology 121:536–541
Jameson JS, Speakman CT, Darzi A et al (1994) Audit of postanal repair in the treatment of fecal incontinence. Dis Colon Rectum 37:369–372
Glasgow SC, Lowry AC (2012) Long-term outcomes of anal sphincter repair for fecal incontinence: a systematic review. Dis Colon Rectum 55:482–490
Altomare DF, Binda GA, Dodi G et al (2004) Disappointing long-term results of the artificial anal sphincter for faecal incontinence. Br J Surg 91:1352–1353
Matzel KE, Lux P, Heuer S et al (2009) Sacral nerve stimulation for faecal incontinence: long-term outcome. Colorectal Dis 11:636–641
Lim JT, Hastie IA, Hiscock RJ et al (2011) Sacral nerve stimulation for fecal incontinence: long-term outcomes. Dis Colon Rectum 54:969–974
Hollingshead JR, Dudding TC, Vaizey CJ (2011) Sacral nerve stimulation for faecal incontinence: results from a single centre over a 10-year period. Colorectal Dis 13:1030–1034
El-Gazzaz G, Zutshi M, Salcedo L et al (2009) Sacral neuromodulation for the treatment of fecal incontinence and urinary incontinence in female patients: long-term follow-up. Int J Colorectal Dis 24:1377–1381
Maeda Y, Lundby L, Buntzen S et al (2014) Outcome of sacral nerve stimulation for fecal incontinence at 5 years. Ann Surg 259:1126–1131
Altomare DF, Ratto C, Ganio E et al (2009) Long-term outcome of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 52:11–17
Hull T, Giese C, Wexner SD et al (2013) SNS Study Group. Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum 56:234–245
Boyle DJ, Murphy J, Gooneratne ML et al (2011) Efficacy of sacral nerve stimulation for the treatment of fecal incontinence. Dis Colon Rectum 54:1271–1278
Giuratrabocchetta S, Robert Yap J et al (2013) Long-term outcome of SNS in the treatment of fecal incontinence. A European Survey. Colorectal Dis 15(Suppl 3):1 (B3) Abstract
Duelund-Jakobsen J, van Wunnik B, Buntzen S, Lundby L, Baeten C, Laurberg S (2012) Functional results and patient satisfaction with sacral nerve stimulation for idiopathic faecal incontinence. Colorectal Dis 14:753–759
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Altomare, D.F., Giuratrabocchetta, S., Giannini, I., De Fazio, M. (2015). Sacral Nerve Modulation for Fecal Incontinence. In: Martellucci, J. (eds) Electrical Stimulation for Pelvic Floor Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-06947-0_13
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DOI: https://doi.org/10.1007/978-3-319-06947-0_13
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