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Preliminary Results of Sacral Transcutaneous Electrical Nerve Stimulation for Fecal Incontinence

Leung, Edmund M.R.C.S., M.D.; Francombe, James F.R.C.S.

Diseases of the Colon & Rectum: March 2013 - Volume 56 - Issue 3 - p 348–353
doi: 10.1097/DCR.0b013e31827aed41
Original Contribution: Pelvic Floor
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BACKGROUND: Fecal incontinence is a common debilitating condition.

OBJECTIVE: The aim of this study is to investigate the feasibility of sacral transcutaneous electrical nerve stimulation as an alternative treatment modality for fecal incontinence.

DESIGN: All consecutive patients who presented with fecal incontinence to the senior author’s clinic were prospectively recruited between June 2009 and September 2010. The severity of their fecal incontinence was assessed by the Wexner and Vaizey scores and anal physiology.

MAIN OUTCOME MEASURES: Any improvement following a period of sacral transcutaneous electrical nerve stimulation treatment was determined by repeating the scores. In addition, patient satisfaction with the procedure was assessed by using a patient impression score.

RESULTS: Twenty female patients with a median age of 57.5 years (range, 30–86) were evaluated. The median follow-up was 10 months (range, 5–12 months). Two patients did not record a change in their Vaizey score. The overall mean Wexner score was 7.9 ± 4.2 before in comparison with 4.0 ± 3.1 after sacral transcutaneous electrical nerve stimulation treatment (p < 0.0001, CI = 2.2–5.7, SE = 0.832). The overall mean Vaizey score was 12.7 ± 5.7 before in comparison with 5.8 ± 5.6 after sacral transcutaneous electrical nerve stimulation treatment (p < 0.0001, CI = 4.5–9.4, SE = 1.162). The pretreatment patient impression score was set at a mean of 1 ± 0 in comparison with 2.8 ± 1.1 after sacral transcutaneous electrical nerve stimulation treatment (p < 0.0001, CI = 1.2–2.3, SE = 0.25).

CONCLUSION: The preliminary results suggest sacral transcutaneous electrical nerve stimulation is a promising noninvasive alternative to existing modalities in the treatment of idiopathic fecal incontinence.

Department of Surgery, Warwick Hospital, Warwick, United Kingdom

Financial Disclosure: None reported.

Podium presentation at the meeting of the American Society of Colon and Rectal Surgeons, San Antonio, Texas, June 2 to 6, 2012.

Correspondence: E. Leung, M.R.C.S., M.D., Warwick Hospital, 16 Norton Dr, Warwick, CV34 5FE United Kingdom. E-mail: ed.leung@doctors.org.uk

© The ASCRS 2013