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Effect of sacral nerve stimulation in patients with fecal and urinary incontinence

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

Abstract

PURPOSE: Preliminary studies have shown improvement in fecal incontinence in several patients who received temporary or permanent stimulation. The purpose of this study was to report our experience in sacral nerve stimulation in the treatment of fecal incontinence and to target patients who would benefit most from stimulation. METHODS: Patients with fecal incontinence were studied clinically and manometrically before, during, and after temporary nerve stimulation. If temporary nerve stimulation was clinically successful, the patient was implanted and followed up for six months. RESULTS: Nine patients (6 female) with a mean age of 50.7 ± 12.3 years underwent temporary nerve stimulation. Temporary nerve stimulation was successful in eight patients, six of whom were implanted. Of the patients who could be evaluated, three of five had improved at the six-month follow-up visit, particularly in relation to the number of urgency episodes and delay in postponing defecation. All implanted patients had urinary symptoms. Urinary urgency was also improved by stimulation. During temporary nerve stimulation, the maximal squeeze pressure amplitude increased. After implantation, only the duration of maximal squeeze pressure seemed to improve. CONCLUSION: Sacral nerve stimulation can be used in the management of fecal incontinence, particularly in cases of urge fecal incontinence associated with urinary urgency. This study seems to confirm the effect of sacral nerve stimulation on striated sphincter function.

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References

  1. Koldewijn EL, Rosier PF, Meuleman EJ, Koster AM, Debruyne FM, Van Kerrebroeck PE. Predictors of success with neuromodulation in lower urinary tract dysfunction: results of trial stimulation in 100 patients. J Urol 1994;152:2071–5.

    PubMed  Google Scholar 

  2. Bosch JL, Groen J. Sacral (S3) segmental nerve stimulation as a treatment for urge-incontinence in patients with detrusor instability: results of chronic electrical stimulation using an implantable neuroprosthesis. J Urol 1995;154:504–7.

    Article  PubMed  Google Scholar 

  3. Vaizey CJ, Kamm MA, Turner IC, Nicholls RJ, Woloszko J. Effects of short term sacral nerve stimulation on anal and rectal function in patients with anal incontinence. Gut 1999;44:407–12.

    PubMed  Google Scholar 

  4. Matzel KE, Stadelmaier U, Hohenfellner M, Gall FP. Electrical stimulation of sacral spinal nerves for treatment of fecal incontinence. Lancet 1995;346:1124–7.

    Article  PubMed  Google Scholar 

  5. Malouf AJ, Vaizey CJ, Nicholls RJ, Kamm MA. Permanent nerve stimulation for fecal incontinence. Ann Surg 2000;232:143–8.

    Article  PubMed  Google Scholar 

  6. Thon WF, Baskin LS, Jonas U, Tangho EA, Schmidt RA. Neuromodulation of voiding dysfunction and pelvic pain. World J Urol 1991;9:138–41.

    Google Scholar 

  7. Siegel SW. Management of voiding dysfunction with an implantable neuroprosthesis. Urol Clin North Am 1992;19:163–70.

    PubMed  Google Scholar 

  8. Klingler HC, Madersbacher S, Djavan B, Schatzl G, Marberger M, Schmidbauer CP. Morbidity of the evaluation of the lower urinary tract with transurethral multichannel pressure flow studies. J Urol 1998;159:191–4.

    PubMed  Google Scholar 

  9. Bouchoucha M, Devroede G, Arhan P,et al. What is the meaning of colorectal transit time measurement? Dis Colon Rectum 1992;35:773–82.

    Article  PubMed  Google Scholar 

  10. Leroi AM, Berkelmans I, Denis P, Hémond M, Devroede G. Anismus as a marker of sexual abuse. Consequences of abuse on anorectal motility. Dis Colon Rectum 1995;40:1411–6.

    Google Scholar 

  11. Denis P, Colin R, Galmiche JP,et al. Elastic properties of the rectal wall in normal adults and in patients with ulcerative colitis. Gastroenterology 1979;77:45–8.

    PubMed  Google Scholar 

  12. Read NW, Harford WV, Schmulen AC, Read MG, Santa Ana C, Fordtran JS. A clinical study of patients with fecal incontinence and diarrhea. Gastroenterology 1979;76:747–56.

    PubMed  Google Scholar 

  13. Abrams PH, Blaivas JG, Stanton SL, Andersen JT. Standardization of terminology of lower urinary tract function. Neurourol Urodyn 1988;7:403–27.

    Google Scholar 

  14. Leroi AM, Weber J, Menard JF, Touchais JY, Denis P. Prevalence of anal incontinence in 409 patients investigated for stress urinary incontinence. Neurourol Urodyn 1999;18:579–90.

    Article  PubMed  Google Scholar 

  15. Christiansen J, Lorentzen M. Implantation of artificial sphincter for anal incontinence: report of five cases. Dis Colon Rectum 1989;32:432–6.

    PubMed  Google Scholar 

  16. Lehur P-A, Michot F, Denis P,et al. Results of artificial sphincter in severe anal incontinence: report of 14 consecutive implantations. Dis Colon Rectum 1996;39:1352–5.

    Google Scholar 

  17. Bosch JL, Groen J. Neuromodulation: urodynamic effects of sacral spinal nerve stimulation in patients with detrusor instability or detrusor hyperflexia. Behav Brain Res 1998;92:141–50.

    Article  PubMed  Google Scholar 

  18. Salmons S, Hendriksson J. The adaptative response of skeletal muscle to increased use. Muscle Nerve 1981;4:94–105.

    Article  PubMed  Google Scholar 

  19. Pette D, Vrbova G. Neural control of phenotypic expression in mammalian muscle fibers. Muscle Nerve 1985;8:676–89.

    Article  PubMed  Google Scholar 

  20. Leroi AM, Karoui S, Touchais JY, Berkelmans I, Denis P. Electrostimulation is not clinically effective treatment of anal incontinence. Eur J Gastroenterol Hepatol 1999;11:1045–7.

    PubMed  Google Scholar 

  21. Vapnek JM, Schmidt RA. Restoration of voiding in chronic urinary retention using the neuroprosthesis. World J Urol 1991;9:142–4.

    Article  Google Scholar 

  22. Craggs M, McFarlane J. Neuromodulation of the lower urinary tract. Exp Physiol 1999;84:149–60.

    PubMed  Google Scholar 

  23. Guyatt G, Drummond M, Feeny D, Haynes RB, Tugwell P. Guidelines for health technology assessment: diagnostic technologies. In: Feeny D, Guyatt G, Tugwell P, eds. Health care technology: effectiveness, efficiency and public policy. Montreal: The Institute for Research and Public Policy, 1986:79–105.

    Google Scholar 

  24. Gee AS, Durdey P. Urge incontinence of faeces is a marker of severe external sphincter dysfunction. Br J Surg 1995;82:1179–82.

    PubMed  Google Scholar 

  25. Khullar V, Damiano R, Toozs-Hobson P, Cardazo L. Prevalence of fecal incontinence among women with urinary incontinence. Br J Obstet Gynaecol 1998;105:1211–3.

    PubMed  Google Scholar 

  26. Dijkema HE, Weil EHJ, Mijs PT, Janknegt RA. Neuromodulation of sacral nerves for incontinence and voiding dysfunctions. Eur Urol 1993;24:72–6.

    Google Scholar 

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Authors and Affiliations

  1. From the Groupe de Recherche de l'Appareil Digestif, Environnement et Nutrition, France

    Anne-Marie Leroi Ph.D., F. Michot Ph.D. & P. Denis Ph.D.

  2. Service d'Urologie, Centre Hospitalier Régional et Universitaire de Rouen, Rouen, France

    P. Grise Ph.D.

Authors
  1. Anne-Marie Leroi Ph.D.
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  2. F. Michot Ph.D.
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  3. P. Grise Ph.D.
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  4. P. Denis Ph.D.
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Leroi, AM., Michot, F., Grise, P. et al. Effect of sacral nerve stimulation in patients with fecal and urinary incontinence. Dis Colon Rectum 44, 779–789 (2001). https://doi.org/10.1007/BF02234695

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