Neuromodulation for fecal incontinence: an effective surgical intervention.
Fecal incontinence is a disabling symptom with medical and social implications, including fear, embarrassment, isolation and even depression. Most patients live in seclusion and have to plan their life around the symptom, with secondary impairment of their quality of life. Conservative management and biofeedback therapy are reported to benefit a good percentage of those affected. However, surgery must be considered in the non-responder population. Recently, sacral nerve electrostimulation, lately named neuromodulation, has been reported to benefit patients with fecal incontinence in randomized controlled trials more than placebo stimulation and conservative management, by some unknown mechanism. Neuromodulation is a minimally invasive procedure with a low rate of adverse events and apparently favorable cost-efficacy profile. This review is intended to expand knowledge about this effective intervention among the non-surgically skilled community who deals with this disabled group of patients.
Giuseppe Chiarioni, Division of Gastroenterology of the University of Verona, Valeggio s/M Hospital, Azienda Ospedaliera Universitaria Integrata di Verona, 37067 Valeggio sul Mincio, Verona, Italy.
Giuseppe
G
Chiarioni
Olafur S
OS
Palsson
Corrado R
CR
Asteria
William E
WE
Whitehead
D001003:Anal Canal / Q000294:innervation*; D000818:Animals; D003672:Defecation; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005242:Fecal Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D058542:Implantable Neurostimulators; D008160:Lumbosacral Plexus / Q000503:physiopathology*; D011788:Quality of Life; D016896:Treatment Outcome
Anal sphincter; Biofeedback; Fecal incontinence; Neuromodulation; Sacral nerve stimulation