Sacral nerve stimulation in faecal incontinence: position statement based on a collective experience.
OBJECTIVE
Since the first paper published by Matzel et al., in 1995, on the efficacy of sacral nerve stimulation (SNS) in patients with faecal incontinence, the indications, the contraindications, the stimulation technique and follow up of implanted patients have changed. The aim of this article was to provide a consensus opinion on the management of patients with faecal incontinence treated with SNS.


METHODS
Recommendations were based on a critical review of the literature when available and on expert opinions in areas with insufficient evidence.


RESULTS
We have reviewed the indications and contraindications, proposed an algorithm for patient management showing the place of SNS. The temporary test technique, the implantation technique, the patient follow up and the approach in case of treatment failure were discussed.


CONCLUSIONS
We hope not only to provide a guide on patient management to clinical practitioners interested in SNS but also to harmonize our practices.
Leroi
A M
AM
ADEN EA 3234/IFRMP 23, Faculté de Médecine de Rouen, France. anne-marie.leroi@chu-rouen.fr
Damon
H
H
Faucheron
J L
JL
Lehur
P A
PA
Siproudhis
L
L
Slim
K
K
Barbieux
J P
JP
Barth
X
X
Borie
F
F
Bresler
L
L
Desfourneaux
V
V
Goudet
P
P
Huten
N
N
Lebreton
G
G
Mathieu
P
P
Meurette
G
G
Mathonnet
M
M
Mion
F
F
Orsoni
P
P
Parc
Y
Y
Portier
G
G
Rullier
E
E
Sielezneff
I
I
Zerbib
F
F
Michot
F
F
D001003:Anal Canal / Q000294:innervation*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D019317:Evidence-Based Medicine; D005242:Fecal Incontinence / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D012445:Sacrococcygeal Region / Q000294:innervation