A systematic review of sacral nerve stimulation mechanisms in the treatment of fecal incontinence and constipation

Carrington, Emma V.; Evers, Judith; Grossi, Ugo; Dinning, Phil G.; Scott, S. M.; O'Connell, P. R.; Jones, James F.; Knowles, Charles H.

doi:10.1111/nmo.12388

Cited by 172 publications

(134 citation statements)

References 105 publications

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“…Thirteen published studies were found reporting the use of SNS for constipation. 201 Ten studies involved adult subjects, including two double-blind crossover studies and three were retrospective reviews. SNS appears to be an effective treatment for constipation; however, research to date has been predominantly confined to small, low-level evidence studies with most lacking a coherent definition of constipation and SNS.…”

Section: Sacral Nerve Stimulationmentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Shin

Jung

Lee

et al. 2016

J Neurogastroenterol Motil

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The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.

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Section: Sacral Nerve Stimulationmentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Shin

Jung

Lee

et al. 2016

J Neurogastroenterol Motil

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“…In a recent systematic study, 53 of 161 clinical studies that investigated cortical, gastrointestinal, rectal, and anal functions and 9 of 43 experimental studies were evaluated. Although sufficient information in this systematic study regarding the mechanism was lacking, it was concluded that the mechanism of action of sacral stimulation on anal dysfunction and constipation may be via pelvic afferents or a central effect, rather than primarily via peripheral motor neurostimulation (46). A significant proportion of findings demonstrate that irritable bowel syndrome and other functional bowel diseases can be treated with sacral stimulation (43).…”

Section: Gastrointestinal Disordersmentioning

confidence: 99%

A Different Option for Neuromodulation Procedures: Sacral Nerve Stimulation

Ozyalcin¹

2015

Turk J Phys Med Rehab

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The aim of this article is to determine the effectiveness and the safety of sacral nerve stimulation on the several indications. Sacral nerve stimulation as a neuromodulation technique, is an effective and increasingly used therapeutic option. As a minimally invasive technique, many advances in the techniques for sacral neuromodulation have been described. The well-known indication of sacral nerve stimulation is the urinary voiding dysfunction. Although the mechanism of neuromodulation is still unclear, multipl new indications have been identified, include faecal incontinence, constipation, pain sydromes, interstitial cystitis, mixt urinary and bowel disoders, spinal injury and neurodegenerative disease, and sexual dysfunction. Since there is lack of high quality evidence of the procedure at present, good quality prospective, cross-over and randomize controlled studies are required to determine the true benefits of sacral nerve stimulation.

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“…According to expert opinion, an improvement of less than 50 % shall result in an extended testing period. An improvement of symptoms of at least 30 % combined with an improved quality of life may be considered an indication for implantation [26,27].…”

Section: Item 48mentioning

confidence: 99%