Fecal Incontinence

Sacral nerve stimulation has been used for fecal incontinence. Ganio et al.8 studied 23 patients with a two-staged approach, five of whom went on to be implanted. Patients had fecal incontinence at least twice every 2 weeks for 2 months, failed biofeedback therapy, and had structurally intact external and internal anal sphincters. Sphincter dysfunction was demonstrated with fecal incontinence associated with low resting and/or squeeze pressures. Seventeen patients had reduction of liquid or solid stool losses by more than 50%, and 14 were completely continent to both liquid and solid stool. In patients with urge incontinence, there was a decrease in losses per week from five to one. Manovolumetric findings showed improvements in maximum resting pressure, rectal sensitivity, first sensa tion, and the distention pressure for urge threshold. Two patients who also had voiding complaints had complete resolution after SNS. Sacral nerve stimulation for fecal incontinence is currently being studied at our institution.

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