Sacral Nerve Stimulation for Fecal Incontinence Related to Obstetric Anal Sphincter Damage

• DOI: 10.1007/s10350-008-9199-2
• Publication Date: 2008-02-26T19:25:19Z
• Authors: Michael E. D. Jar...; Thomas C. Dudding; R. John Nicholls; Carolynne J. Vaizey; C. Richard G. Cohen; Michael A. Kamm
• Keywords: Fecal Incontinence; External anal sphincter; Anorectal manometry; Colorectal Surgery

Sphincter repair is the standard treatment for fecal incontinence secondary to obstetric external anal sphincter damage; however, results of this deteriorate over time. Sacral nerve stimulation has become an established therapy in patients with intact muscles. This study investigated its efficacy as a obstetric-related incontinence.Fecally incontinent defects who would normally have undergone overlapping primary or repeat procedure were included. Eight consecutive women (median age, 46 (range, 35-67) years) completed temporary screening; all eventually had permanent implantation.Six eight improved continence at median follow-up 26.5 6-40) months. Fecal episodes from 5.5 4.5-18) 1.5 0-5.5) per week (P = 0.0078). Urgency five patients, ability defer defecation improving <1 0-5) minute 1 5 >15) minutes 0.031, 8 patients). There was no change manometry rectal sensation. significant improvement lifestyle, coping/behavior, depression/self-perception, and embarrassment measured by American Society Colon Rectal Surgery quality life score.Sacral potentially safe effective minimally invasive de novo after unsuccessful previous repair, although numbers remain small.