Sacral spinal nerve stimulation for faecal incontinence: multicentre study

Summary Background In patients with faecal incontinence in whom conservative treatment fails, options are limited for those with a functionally deficient but morphologically intact sphincter. We investigated the effect of sacral nerve stimulation on continence and quality of life. Methods In this multicentre prospective trial, 37 patients underwent a test stimulation period, followed by implantation of a neurostimulator for chronic stimulation in 34. Effect on continence was assessed by daily bowel-habit diaries over a 3-week period and on quality of life by the disease-specific American Society of Colon and Rectal Surgeons (ASCRS) questionnaire and the standard short form health survey questionnaire (SF-36). Every patient served as his or her own control. Findings Frequency of incontinent episodes per week fell (mean 16·4 vs 3·1 and 2·0 at 12 and 24 months; p vs 1·4 and 1·2 at 12 and 24 months, p vs 2·4 at 12 months; p vs 3·7 at 12 months; p Interpretation Sacral nerve stimulation greatly improves continence and quality of life in selected patients with morphologically intact or repaired sphincter complex offering a treatment for patients in whom treatment options are limited.