Sacral Nerve Stimulation for Faecal Incontinence Following a Rectosigmoid Resection for Colorectal Cancer

Overview

Journal Int J Colorectal Dis

Specialties Gastroenterology
General Surgery

Date 2005 Apr 22

PMID 15843939

Citations 12

Authors

Michael E D Jarrett

Klaus E Matzel

Michael Stosser

John Christiansen

Harald Rosen

Michael A Kamm

Affiliations

Soon will be listed here.

Abstract

Introduction: Following recto-sigmoid resection some patients may become faecally incontinent and remain so despite conservative treatment. This multicentre prospective study assessed the use of sacral nerve stimulation (SNS) in this group.

Methods: All patients had more than or equal to 4 days of faecal incontinence for solid or liquid stools over a 21-day period following recto-sigmoid resection for colorectal carcinoma. The operation had to have been deemed curative. They had to have failed pharmacological and biofeedback treatment.

Results: Three male patients met these criteria. One had had a colo-anal and two a colo-rectal anastomosis for rectal carcinoma. All patients had intact internal and external anal sphincters. Two patients had a successful temporary stimulation period and proceeded to permanent implantation. Pre-operative symptom duration was 1 year in the permanently implanted patients. They were followed up for 12 months. SNS improved the number of faecally incontinent episodes in both patients. Ability to defer was improved in both patients from 0--5 min to 5--15 min. The faecal incontinence-specific ASCRS quality of life assessment improved in all four subcategories.

Conclusion: This study demonstrates that SNS may be effective in the treatment of patients with faecal incontinence following recto-sigmoid resection if conservative treatment has failed.

Citing Articles

Low anterior resection syndrome.

Ryoo S Ann Gastroenterol Surg. 2023; 7(5):719-724.

PMID: 37663958 PMC: 10472409. DOI: 10.1002/ags3.12695.

Sacral neuromodulation for low anterior resection syndrome: current status-a systematic review and meta-analysis.

Pires M, Severo M, Lopes A, Neves S, Matzel K, Povo A Int J Colorectal Dis. 2023; 38(1):189.

PMID: 37428256 DOI: 10.1007/s00384-023-04485-8.

The efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome: a systematic review and meta-analysis.

Ram E, Meyer R, Carter D, Gutman M, Rosin D, Horesh N Tech Coloproctol. 2020; 24(8):803-815.

PMID: 32350733 DOI: 10.1007/s10151-020-02231-8.

Effectiveness of sacral nerve stimulation in fecal incontinence after multimodal oncologic treatment for pelvic malignancies: a multicenter study with 2-year follow-up.

Schiano di Visconte M, Santoro G, Cracco N, Sarzo G, Bellio G, Brunner M Tech Coloproctol. 2018; 22(2):97-105.

PMID: 29313165 DOI: 10.1007/s10151-017-1745-2.

Treatment possibilities for low anterior resection syndrome: a review of the literature.

Dulskas A, Smolskas E, Kildusiene I, Samalavicius N Int J Colorectal Dis. 2018; 33(3):251-260.

PMID: 29313107 DOI: 10.1007/s00384-017-2954-x.

References

Ho Y . Postanal sphincter repair for anterior resection anal sphincter injuries: report of three cases. Dis Colon Rectum. 2001; 44(8):1218-20. DOI: 10.1007/BF02234648. View

Siegel S . Management of voiding dysfunction with an implantable neuroprosthesis. Urol Clin North Am. 1992; 19(1):163-70. View

Ganio E, Luc A, Clerico G, Trompetto M . Sacral nerve stimulation for treatment of fecal incontinence: a novel approach for intractable fecal incontinence. Dis Colon Rectum. 2001; 44(5):619-29; discussion 629-31. DOI: 10.1007/BF02234555. View

Rockwood T, Church J, Fleshman J, Kane R, Mavrantonis C, Thorson A . Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum. 2000; 43(1):9-16; discussion 16-7. DOI: 10.1007/BF02237236. View

Farouk R, Duthie G, Lee P, Monson J . Endosonographic evidence of injury to the internal anal sphincter after low anterior resection: long-term follow-up. Dis Colon Rectum. 1998; 41(7):888-91. DOI: 10.1007/BF02235373. View

Matzel K, Stadelmaier U, Bittorf B, Hohenfellner M, Hohenberger W . Bilateral sacral spinal nerve stimulation for fecal incontinence after low anterior rectum resection. Int J Colorectal Dis. 2002; 17(6):430-4. DOI: 10.1007/s00384-002-0412-9. View

Matzel K, Stadelmaier U, Hohenfellner M, Gall F . Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet. 1995; 346(8983):1124-7. DOI: 10.1016/s0140-6736(95)91799-3. View

Matzel K, Stadelmaier U, Hohenfellner M, Gall F . [Permanent electrostimulation of sacral spinal nerves with an implantable neurostimulator in treatment of fecal incontinence]. Chirurg. 1995; 66(8):813-7. View

Lewis W, Martin I, Williamson M, Stephenson B, Holdsworth P, Finan P . Why do some patients experience poor functional results after anterior resection of the rectum for carcinoma?. Dis Colon Rectum. 1995; 38(3):259-63. DOI: 10.1007/BF02055598. View

10.

Malouf A, Vaizey C, Nicholls R, Kamm M . Permanent sacral nerve stimulation for fecal incontinence. Ann Surg. 2000; 232(1):143-8. PMC: 1421119. DOI: 10.1097/00000658-200007000-00020. View

11.

Matzel K, Stadelmaier U, Muehldorfer S, Hohenberger W . Continence after colorectal reconstruction following resection: impact of level of anastomosis. Int J Colorectal Dis. 1997; 12(2):82-7. DOI: 10.1007/s003840050086. View

12.

Williamson M, Lewis W, Holdsworth P, Finan P, Johnston D . Decrease in the anorectal pressure gradient after low anterior resection of the rectum. A study using continuous ambulatory manometry. Dis Colon Rectum. 1994; 37(12):1228-31. DOI: 10.1007/BF02257786. View

13.

Vaizey C, Kamm M, Roy A, Nicholls R . Double-blind crossover study of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum. 2000; 43(3):298-302. DOI: 10.1007/BF02258292. View

14.

Kenefick N, Vaizey C, Nicholls R, Cohen R, Kamm M . Sacral nerve stimulation for faecal incontinence due to systemic sclerosis. Gut. 2002; 51(6):881-3. PMC: 1773465. DOI: 10.1136/gut.51.6.881. View

15.

Bosch J, Groen J . Sacral (S3) segmental nerve stimulation as a treatment for urge incontinence in patients with detrusor instability: results of chronic electrical stimulation using an implantable neural prosthesis. J Urol. 1995; 154(2 Pt 1):504-7. DOI: 10.1097/00005392-199508000-00045. View

16.

Kenefick N, Vaizey C, Cohen R, Nicholls R, Kamm M . Medium-term results of permanent sacral nerve stimulation for faecal incontinence. Br J Surg. 2002; 89(7):896-901. DOI: 10.1046/j.1365-2168.2002.02119.x. View

17.

Karanjia N, Schache D, Heald R . Function of the distal rectum after low anterior resection for carcinoma. Br J Surg. 1992; 79(2):114-6. DOI: 10.1002/bjs.1800790206. View

18.

Leroi A, Michot F, Grise P, Denis P . Effect of sacral nerve stimulation in patients with fecal and urinary incontinence. Dis Colon Rectum. 2001; 44(6):779-89. DOI: 10.1007/BF02234695. View

19.

Law P, Bartram C . Anal endosonography: technique and normal anatomy. Gastrointest Radiol. 1989; 14(4):349-53. DOI: 10.1007/BF01889235. View

20.

Matzel K, Bittorf B, Gunther K, Stadelmaier U, Hohenberger W . Rectal resection with low anastomosis: functional outcome. Colorectal Dis. 2003; 5(5):458-64. DOI: 10.1046/j.1463-1318.2003.t01-1-00503.x. View