Effect of sacral nerve stimulation in patients with fecal and urinary incontinence

PURPOSE: Preliminary studies ha c e shown improvement in fecal incontinence in several patients who received temporary or permanent stimulation. The p urpose of this study was to report our experience in sacral nerve stimulati on in the treatment of fecal incontinence and to target patients who would benefit most from stimulation. METHODS: Patients with fecal incontinence we re studied clinically and manometrically before, during, and after temporar y nerve stimulation, if temporary nerve stimulation was clinically successf ul, the patient was implanted and followed up for six months. RESULTS: Nine patients (G female) with a mean age of 50.7 +/- 12.3 years underwent tempo rary nerve stimulation. Temporary nerve stimulation was successful in eight patients, six of whom were implanted. Of the patients who could be evaluat ed, three of five had improved at the six-month follow-up visit, particular ly in relation to the number of urgency episodes and delay in postponing de fecation. ALL implanted patients had urinary symptoms. Urinary urgency was also improved by stimulation. During temporary nerve stimulation, the maxim al squeeze pressure amplitude increased. After implantation, only the durat ion of maximal squeeze pressure seemed to improve. CONCLUSION: Sacral nerve stimulation can be used in the management of fecal incontinence, particula rly in cases of urge fecal incontinence associated with urinary urgency. Th is study seems to confirm the effect of sacral nerve stimulation on striate d sphincter function.