title: Sacral nerve stimulation for the treatment of severe faecal incontinence: results after 10 years experience.
abstract: BACKGROUND
  The objective of this study is to report our experience with sacral nerve stimulation for the treatment of severe faecal incontinence after the first 10 years with this technique.
  
  
  METHODS
  Between 2001 and 2011, 49 patients with severe faecal incontinence underwent sacral nerve stimulation. Anorectal manometry, endoanal ultrasound and pudendal nerve latency were performed. Bowel habit diary, severity of faecal incontinence and quality of life scales were evaluated preoperatively and at the end of follow-up.
  
  
  RESULTS
  Morbidity occurred in a third of patients, mostly minor. Four definitive devices were explanted. With a median follow-up of 37 months, severity of faecal incontinence, urge and incontinence episodes significantly improved at the end of follow-up. Patients' subgroup with major follow-up of 5 years significantly improved the severity of faecal incontinence but not the parameters of the bowel habit diary. Quality of life showed no significant improvement. Descriptive data in patients with sphincter defects did not show worse results than with sphincter integrity.
  
  
  CONCLUSIONS
  Sacral nerve stimulation is a safe technique for severe faecal incontinence with good functional medium-term results. In the long term, severity of the faecal incontinence also improves but studies with larger sample are necessary to show if other clinical parameters and the quality of life support this information. Preliminary results in patients with sphincter defects suggest that this technique could be effective in this group but future studies will have to confirm these findings.
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital de Sagunto, Valencia, España. Electronic address: ruiz.lola@hotmail.com.
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Ruiz Carmona
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital de Sagunto, Valencia, España.
authors.forename: José
authors.initials: J
authors.lastname: Martín Arévalo
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital de Sagunto, Valencia, España.
authors.forename: David
authors.initials: D
authors.lastname: Moro Valdezate
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital de Sagunto, Valencia, España.
authors.forename: Vicente
authors.initials: V
authors.lastname: Plá Martí
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital de Sagunto, Valencia, España.
authors.forename: Félix
authors.initials: F
authors.lastname: Checa Ayet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D058542:Implantable Neurostimulators; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D062187:Spinal Cord Stimulation; D013997:Time Factors; D055815:Young Adult
keywords: Defectos esfinterianos; Faeecal incontinence; Incontinencia fecal; Neuromodulación sacra; Sacral nerve stimulation; Sphincter defects