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- Title
Sacral nerve stimulation for faecal incontinence in patients with sacral malformation.
- Authors
Brunner, M.; Cui, Z.; Matzel, K.
- Abstract
Introduction: Sacral nerve stimulation (SNS) is a common and effective treatment for faecal incontinence (FI), but accessibility of the sacral nerves is mandatory. In some cases, electrode placement fails for unknown reasons. A frequent cause could be sacral malformations, which have a high incidence (up to 24.1%) and can be unsuspected. Methods and results: We report two patients with FI consequent to congenital anorectal malformation and associated sacral malformation. Despite partial sacral agenesis, SNS was feasible in both. They benefitted greatly from SNS, with an improved ability to postpone the urge up to at least 15 min, reduced incontinence episodes (at least 50%), and significantly better quality of life. Conclusion: SNS may be feasible in patients with FI, even in the presence of sacral malformation. However, clinicians should be aware of the attendant technical difficulties. Preoperative imaging, preferably with MRI of the sacrum, is advisable. If the sacral spinal nerves are inaccessible technically, pudendal nerve stimulation could be considered, if anatomy permits.
- Subjects
IMPERFORATE anus; HEART valve diseases; NEURAL stimulation; SACRUM diseases; BOWEL obstructions; PATIENTS
- Publication
International Journal of Colorectal Disease, 2017, Vol 32, Issue 6, p929
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-016-2748-6