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 20 November 2017

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News

Sacral-nerve stimulation could help counteract incontinence

Results of a small trial in this week's issue of the Lancet suggest that electrical stimulation of the sacral nerve could be a future treatment option for fecal incontinence.

News image

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Anal incontinence affects an estimated 2% of the general population.

Its prevalence rises with age, affecting up to 11% of men and 26% of women older than 50 years.
Quality-of-life scores showed an improvement after treatment.
Lancet

Treatment options are limited for patients with fecal incontinence in whom conservative treatment fails.

In this study, Dr Klaus Matzel from the University of Nuremberg, Germany, and colleagues investigated the effect of sacral nerve stimulation on continence and quality of life.

Overall, 34 patients from 8 medical centers had electrodes implanted to stimulate the sacral nerve, facilitating greater control of the anal sphincter.

Patients were asked to keep a record of incontinence episodes and were followed up at various intervals up to 3 years after the start of the study.

The team found that stimulation of the sacral nerve greatly reduced the number of weekly episodes of incontinence. Episodes occurred approximately 16 times per week at the start of the study. This dropped to 3 per week after 1 year and 2 per week after 2 years.

Other measures of incontinence were also reduced.

Quality-of-life scores were also assessed and showed an improvement after treatment.

Dr Matzel commented, "Our trial has shown a convincing benefit of sacral nerve stimulation to continence and quality of life for patients with fecal incontinence".

"The technique is relatively simple, and its practicality is enhanced by the predictive value of a staged approach, in which every patient serves as his or her own control".

"With its low morbidity, sacral nerve stimulation is a safe and effective option for patients with an intact or repaired anal sphincter".

"When conventional treatment is inappropriate or ineffective, it should be considered before sphincter replacement or stoma creation".

Lancet 2004; 363: 1270-6
16 April 2004

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