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International Journal of Colorectal Disease

Published in:

01-03-2011 | Original Article

Meta-analysis: sacral nerve stimulation versus conservative therapy in the treatment of faecal incontinence

Authors: Emile Tan, Nye-Thane Ngo, Ara Darzi, Michael Shenouda, Paris P. Tekkis

Published in: International Journal of Colorectal Disease | Issue 3/2011

Abstract

Aim

Sacral nerve stimulation (SNS) has recently been used in the management of faecal incontinence (FI). This study compared SNS to conservative management with regards to functional and quality of life outcomes.

Methods

Meta-analysis of studies published between 1995 and 2008 on SNS for FI was performed. Outcomes evaluated were functional, physiological and quality of life. A random-effects model was used and sensitivity analyses performed. Subgroup analyses were performed on age and sphincter status.

Results

Thirty-four studies were included, reporting on 944 patients undergoing peripheral nerve evaluation; 665 underwent permanent SNS. Weekly incontinence episodes (weighted mean difference [WMD] −6.83; 95% confidence intervals [CI] −8.05, −5.60; p < 0.001) and incontinence scores (WMD −10.57; 95% CI −11.89, −9.24; p < 0.001) were significantly reduced with SNS; ability to defer defecation (WMD 7.99 min; 95% CI 5.93, 10.05; p < 0.001) was increased. Most SF-36 and FIQL domains improved following SNS, and mean anal pressures increased significantly (p < 0.001). Results remained consistent on sensitivity analysis. The under-56 years age group showed smaller functional but greater physiological and quality of life improvements. Results were similar between sphincter intact and impaired subgroups. The complication rate was 15% for permanent SNS, with 3% resulting in permanent explantation.

Conclusion

SNS results in significant improvements in objective and subjective measures for faecally incontinent patients.

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Title: Meta-analysis: sacral nerve stimulation versus conservative therapy in the treatment of faecal incontinence
Authors: Emile Tan
Nye-Thane Ngo
Ara Darzi
Michael Shenouda
Paris P. Tekkis
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 3/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-010-1119-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Meta-analysis: sacral nerve stimulation versus conservative therapy in the treatment of faecal incontinence

Abstract

Aim

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Methods

Results

Conclusion

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