Sacral nerve stimulation as a treatment for fecal incontinence

Gastroenterology. 2001 Sep;121(3):536-41. doi: 10.1053/gast.2001.27120.


Background & aims: Sacral nerve stimulation is a proven therapeutic option for the treatment of some forms of urinary incontinence. Very recently, preliminary reports have given evidence for its efficacy in fecal incontinence (FI) too.

Methods: Since November 1998, 20 patients have been treated for severe FI. The cause of FI was mainly neurologic (n = 15), and was idiopathic in 5 patients. After temporary (subchronic) external stimulation over a period of 10-14 days, patients whose continence status improved underwent implantation of a permanent quadripolar lead and a subcutaneously implanted pulse generator.

Results: Acute (needle) testing revealed a positive pelvic floor response in 16 patients who underwent subsequent permanent implantation. The median number of incontinence episodes decreased from 6 episodes (3-15/21 days) to 2 (0-5/21 days). The time period of retention of a volume of saline causing an urge until definitive defecation was 2 minutes (range, 0-5 minutes) preoperatively and increased to 7.5 minutes (2-15 minutes) postoperatively. Results of preoperative and postoperative (3 months) anal manometry showed a statistically significant increase in maximal resting and squeeze pressures.

Conclusions: Sacral nerve stimulation seems to be a new and promising modality for patients with certain types of FI in whom conventional treatment options have failed to achieve an improvement.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Defecation
  • Electric Stimulation Therapy*
  • Fecal Incontinence / diagnosis
  • Fecal Incontinence / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypogastric Plexus / physiology*
  • Male
  • Manometry
  • Middle Aged
  • Postoperative Complications
  • Rectum / innervation*
  • Rectum / physiology
  • Sacrum
  • Treatment Outcome