Sacral Neuromodulation for the Treatment of Faecal Incontinence: First Steps in Lithuania

Abstract

SummaryTwo female patients with faecal incontinence resistant to conservative treatment but improved after percutaneous tibial nerve neuromodulation were treated with sacral nerve neuromodulation in 2014. Quality of Life questionnaires were used in order to determine the impact of faecal incontinence on everyday life before and after the implantation of the stimulator. To evaluate the functional state, Wexner's questionnaires were applied. Bowel movement diary was used to detect the improvement of faecal continence before and after temporary and permanent neuromodulation. The data were analyzed using a Statistical Package for Social Sciences program (SPSS, version 22.0). All values were given as mean ± SD. P-values less than 0.05 were accepted to indicate statistical significance. Both patients had a reduction in episodes of incontinence and soiling during a 3 week temporary nerve stimulation period as well as during 3 week followup after permanent stimulator implantation. Statistically significant elevation of faecal urgency frequency (p=0.031) was observed during temporary nerve stimulation. Reduction of episodes of faecal incontinence (p=0.001) and soiling (p=0.000) was observed after permanent stimulator implantation. Both patients presented an improvement in lifestyle, coping, depression and embarrassment as well as an improvement in functional state 3 weeks after the beginning of sacral nerve stimulation. Conclusions: The first results of sacral neuromodulation in patients with faecal incontinence are excellent and very promising.