This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Sacral nerve stimulation for neurogenic faecal incontinence. BJS 2007; 94: 749-753.

Published: 4th April 2007

Authors: B. Holzer, H. R. Rosen, G. Novi, C. Ausch, N. Hölbling, R. Schiessel et al.

Background

Sacral nerve stimulation (SNS) has emerged as a promising technique for the treatment of faecal incontinence. This study assessed the outcome of SNS in a cohort of patients with incontinence of neurological aetiology.

Method

Thirty‐six patients were included in a trial of SNS. Twenty‐nine subsequently had a permanent implant. Evaluation consisted of a continence diary, anal manometry, saline retention testing and quality of life assessment.

Results

After a median follow‐up of 35 (range 3–71) months, 28 patients showed a marked improvement in or complete recovery of continence. Incontinence to solid or liquid stool decreased from a median of 7 (range 4–15) to 2 (range 0–5) episodes in 21 days (P = 0·002). Saline retention time increased from a median of 2 (range 0–5) to 7 (range 2–15) min (P = 0·002). Maximum resting and squeeze anal canal pressures increased compared with preoperative values. Quality of life on all scales among patients who received a permanent implant increased at 12 and 24 months after operation.

Conclusion

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