Sacral nerve stimulation for neurogenic faecal incontinence

Holzer, Brigitte; Rosén, Harald; Novi, Gabriele; Ausch, Christoph; Hölbling, N.; Schiessel, R

doi:10.1002/bjs.5499

Cited by 103 publications

(72 citation statements)

References 14 publications

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“…Nine studies (aggregate N ¼ 137) evaluated the effects of surgical implantation of electrical stimulation systems (Table 10). [51][52][53][54][55][56][57][58][59] There is Level 2 evidence (from one prospective, non-randomizedcontrolled trial) 51 that supports the use of sacral anterior root stimulation to reduce severe constipation in complete injuries. Binnie et al 51 had found that an implanted Brindley stimulator did not reduce oro-cecal time for individuals with Figure 2 Schematic diagram of the enema continence catheter.…”

Section: Resultsmentioning

confidence: 99%

“…57,58 Conflicting evidence exists, however, on the effects of resting and squeeze canal pressures. 57,58 Level 4 evidence also exists in support of sacral nerve stimulation in the treatment of fecal incontinence in patients suffering from cauda equine syndrome. 55 Gstaltner et al 55 found an improved fecal continence, quality of life, and deliberate retention of feces in all subjects.…”

Section: Resultsmentioning

confidence: 99%

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Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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Study design: Randomized-controlled trials (RCTs), prospective cohort, case-control, pre-post studies, and case reports that assessed pharmacological and non-pharmacological intervention for the management of the neurogenic bowel after spinal cord injury (SCI) were included. Objective: To systematically review the evidence for the management of neurogenic bowel in individuals with SCI. Setting: Literature searches were conducted for relevant articles, as well as practice guidelines, using numerous electronic databases. Manual searches of retrieved articles from 1950 to July 2009 were also conducted to identify literature. Methods: Two independent reviewers evaluated each study's quality, using Physiotherapy Evidence Database scale for RCTs and Downs and Black scale for all other studies. The results were tabulated and levels of evidence assigned. Results: A total of 2956 studies were found as a result of the literature search. On review of the titles and abstracts, 57 studies met the inclusion criteria. Multifaceted programs are the first approach to neurogenic bowel and are supported by lower levels of evidence. Of the non-pharmacological (conservative and non-surgical) interventions, transanal irrigation is a promising treatment to reduce constipation and fecal incontinence. When conservative management is not effective, pharmacological interventions (for example prokinetic agents) are supported by strong evidence for the treatment of chronic constipation. When conservative and pharmacological treatments are not effective, surgical interventions may be considered and are supported by lower levels of evidence in reducing complications. Conclusions: Often, more than one procedure is necessary to develop an effective bowel routine. Evidence is low for non-pharmacological approaches and high for pharmacological interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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“…12 Improvement of the sensory function of the rectal ampulla, as well as a late effect on the anal sphincter muscles (although we were not able to prove this in our own series), could be responsible for the positive influence of this method on the function of this situation (incontinence score) and quality of life. [12][13] As SNM has recently been reported to have positive although controversial results in patients with chronic constipation, it could be discussed whether patients with symptoms of rectal prolapse should undergo the minimally invasive procedure of the test stimulation before being transferred to more aggressive and sometimes nonreversible surgical procedures. 14 -15 Based on these preliminary results with a limited number of patients, as well as the partially pessimistic success rates of existing procedures, further studies with a test phase of SNM (2-3 weeks) before planned surgical repair of rectal prolapse could be warranted.…”

Section: Discussionmentioning

confidence: 99%

Sacral Nerve Modulation in the Treatment of Fecal Incontinence Following Repair of Rectal Prolapse

Robert‐Yap

Zufferey

Rosén³

et al. 2010

Diseases of the Colon &Amp; Rectum

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“…Additionally, there was an improvement noted in quality of life. 93 Patients with cauda equina syndrome having flaccid paresis of anal sphincters also achieved an improvement in continence after SNS. 94 Lombardi Figure 2: Peristeen TM anal irrigation system …”

Section: Sacral Neuromodulationmentioning

confidence: 92%

Evaluation and Treatment of Neurogenic Bowel Dysfunction – A Review

Kumar¹,

Athanasakos²,

Emmanuel³

2016

European Neurological Review

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Neurogenic bowel dysfunction is a severely troubling entity for patients with neurological disease or injury. The complex symptom cluster presents a challenge, not only for the patients but also for the treating clinician. Without intervention, patients are bound to have a reduced quality of life, and experience social impacts and secondary complications that come along with it. A careful initial assessment provides an idea of symptom severity and is crucial for successful rehabilitation. The mainstay of treatment remains a conservative approach of managing faecal incontinence or optimising the mechanics of defecation to improve patient’s quality of life. This article attempts to provide a comprehensive review of existing literature on pathophysiology, assessment and management of neurogenic bowel dysfunction.

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Sacral nerve stimulation for neurogenic faecal incontinence

Abstract: SNS is of value in selected patients with neurogenic faecal incontinence.

Cited by 103 publications

References 14 publications

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

Sacral Nerve Modulation in the Treatment of Fecal Incontinence Following Repair of Rectal Prolapse

Evaluation and Treatment of Neurogenic Bowel Dysfunction – A Review

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