Zentralbl Chir 2012; 137(4): 335-339
DOI: 10.1055/s-0032-1315140
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Die sakrale Nervenstimulation im Behandlungskonzept der Stuhlinkontinenz

Sacral Nerve Stimulation (SNS) in the Treatment of Faecal Incontinence
M. Goos
1   Abteilung für Allgemein- und Viszeralchirurgie, Chirurgische Universitätsklinik Freiburg, Freiburg im Breisgau, Deutschland
,
G. Ruf
1   Abteilung für Allgemein- und Viszeralchirurgie, Chirurgische Universitätsklinik Freiburg, Freiburg im Breisgau, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
29 August 2012 (online)

Zusammenfassung

Die Sakralnervenstimulation (SNS) hat sich zu einem wichtigen Standbein der Inkontinenzbehandlung entwickelt. Idiopathische, muskuläre und neurogene Störungen lassen sich erfolgreich behandeln. Komplikationen wie Serome, Kabelbrüche oder Elektrodendislokationen können konservativ behandelt werden. Bei einigen Patienten jedoch können operative Revisionen oder die Explantation des Stimulationssystems erforderlich sein.

Abstract

Sacral nerve stimulation (SNS, sacral neuromodulation) has become an important tool in the treatment of incontinence. Idiopathic, muscular as well as neurogenous disorders can be treated successfully with this method. Possible complications like infections, cable breaks and electrode displacements may be treated very well conservatively. However, in some patients a surgical revision or removal of the stimulation system may be necessary.

 
  • Literatur

  • 1 Tan E, Ngo NT, Darzi A et al. Meta-analysis: sacral nerve stimulation versus conservative therapy in the treatment of faecal incontinence. Int J Colorectal Dis 2011; 26: 275-294
  • 2 Madoff RD, Parker SC, Varma MG et al. Faecal incontinence in adults. Lancet 2004; 364: 621-632
  • 3 Faltin DL, Sangalli MR, Roche B et al. Does a second delivery increase the risk of anal incontinence?. BJOG 2001; 108: 684-688
  • 4 Sharma A, Marshall RJ, Macmillan AK et al. Determining levels of fecal incontinence in the community: a New Zealand cross-sectional study. Dis Colon Rectum 2011; 54: 1381-1387
  • 5 Borrie MJ, Davidson HA. Incontinence in institutions: costs and contributing factors. CMAJ 1992; 147: 322-328
  • 6 Cheung O, Wald A. Review article: the management of pelvic floor disorders. Aliment Pharmacol Ther 2004; 19: 481-495
  • 7 Cook TA, Mortensen NJ. Management of faecal incontinence following obstetric injury. Br J Surg 1998; 85: 293-299
  • 8 Keighley MR, Fielding JW. Management of faecal incontinence and results of surgical treatment. Br J Surg 1983; 70: 463-468
  • 9 Norton C, Kamm MA. Anal sphincter biofeedback and pelvic floor exercises for faecal incontinence in adults–a systematic review. Aliment Pharmacol Ther 2001; 15: 1147-1154
  • 10 Norton C, Kamm MA. Anal plug for faecal incontinence. Colorectal Dis 2001; 3: 323-327
  • 11 Mortensen N, Humphreys MS. The anal continence plug: a disposable device for patients with anorectal incontinence. Lancet 1991; 338: 295-297
  • 12 Brosa M, Munoz-Duyos A, Navarro-Luna A et al. Cost-effectiveness analysis of sacral neuromodulation (SNM) with Interstim for fecal incontinence patients in Spain. Curr Med Res Opin 2008; 24: 907-918
  • 13 Madoff RD. Surgical treatment options for fecal incontinence. Gastroenterology 2004; 126: S48-S54
  • 14 Person B, Wexner SD. Advances in the surgical treatment of fecal incontinence. Surg Innov 2005; 12: 7-21
  • 15 Tan JJ, Chan M, Tjandra JJ. Evolving therapy for fecal incontinence. Dis Colon Rectum 2007; 50: 1950-1967
  • 16 Caldwell KP. The use of electrical stimulation in urinary retention and incontinence. Proc R Soc Med 1968; 61: 703-703
  • 17 Christiansen J, Lorentzen M. Implantation of artificial sphincter for anal incontinence. Lancet 1987; 2: 244-245
  • 18 Matzel KE, Stadelmaier U, Hohenfellner M et al. Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet 1995; 346: 1124-1127
  • 19 Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology 1973; 1: 252-259
  • 20 Wong WD, Jensen LL, Bartolo DC et al. Artificial anal sphincter. Dis Colon Rectum 1996; 39: 1345-1351
  • 21 Wong WD, Congliosi SM, Spencer MP et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. Dis Colon Rectum 2002; 45: 1139-1153
  • 22 Tanagho EA, Schmidt RA. Bladder pacemaker: Scientific basis and clinical future. Urology 1982; 20: 614-619
  • 23 Matzel KE, Schmidt RA, Tanagho EA. Neuroanatomy of the striated muscular anal continence mechanism. Implications for the use of neurostimulation. Dis Colon Rectum 1990; 33: 666-673
  • 24 Lehur PA, Glemain P, Bruley des Varannes S et al. Outcome of patients with an implanted artificial anal sphincter for severe faecal incontinence. A single institution report. Int J Colorectal Dis 1998; 13: 88-92
  • 25 Baeten CG, Bailey HR, Bakka A et al. Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum 2000; 43: 743-751
  • 26 Matzel KE, Madoff RD, LaFontaine LJ et al. Complications of dynamic graciloplasty: incidence, management, and impact on outcome. Dis Colon Rectum 2001; 44: 1427-1435
  • 27 Jarrett ME, Mowatt G, Glazener CM et al. Systematic review of sacral nerve stimulation for faecal incontinence and constipation. Br J Surg 2004; 91: 1559-1569
  • 28 Hetzer FH, Hahnloser D, Clavien PA et al. Quality of life and morbidity after permanent sacral nerve stimulation for fecal incontinence. Arch Surg 2007; 142: 8-13
  • 29 Chapman AE, Geerdes B, Hewett P et al. Systematic review of dynamic graciloplasty in the treatment of faecal incontinence. Br J Surg 2002; 89: 138-153
  • 30 Mundy L, Merlin TL, Maddern GJ et al. Systematic review of safety and effectiveness of an artificial bowel sphincter for faecal incontinence. Br J Surg 2004; 91: 665-672
  • 31 Engel AF, Kamm MA, Sultan AH et al. Anterior anal sphincter repair in patients with obstetric trauma. Br J Surg 1994; 81: 1231-1234
  • 32 Bachoo P, Brazzelli M, Grant A. Surgery for faecal incontinence in adults. Cochrane Database Syst Rev 2000; (2) CD001757
  • 33 Malouf AJ, Norton CS, Engel AF et al. Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet 2000; 355: 260-265
  • 34 Baig MK, Wexner SD. Factors predictive of outcome after surgery for faecal incontinence. Br J Surg 2000; 87: 1316-1330
  • 35 Bravo GA, Madoff RD, Lowry AC et al. Long-term results of anterior sphincteroplasty. Dis Colon Rectum 2004; 47: 727-731
  • 36 El-Gazzaz GMD, Zutshi MMD, Hannaway CMD et al. Overlapping sphincter repair: Does age matter?. Dis Colon Rectum 2012; 55: 256-261
  • 37 Maeda Y, Laurberg S. Sacral nerve stimulation: time for critical appraisal. Ann Surg 2011; 254: 174-175
  • 38 Rosen HR, Urbarz C, Holzer B et al. Sacral nerve stimulation as a treatment for fecal incontinence. Gastroenterology 2001; 121: 536-541
  • 39 Wexner SD, Hull T, Edden Y et al. Infection rates in a large investigational trial of sacral nerve stimulation for fecal incontinence. J Gastrointest Surg 2010; 14: 1081-1089
  • 40 Chai TC, Mamo GJ. Modified techniques of S3 foramen localization and lead implantation in S3 neuromodulation. Urology 2001; 58: 786-790
  • 41 Schmidt RA, Jonas U, Oleson KA et al. Sacral nerve stimulation for treatment of refractory urinary urge incontinence. Sacral Nerve Stimulation Study Group. J Urol 1999; 162: 352-357
  • 42 Gallas S, Michot F, Faucheron JL et al. Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: results of trial stimulation in 200 patients. Colorectal Disease 2011; 13: 689-696
  • 43 Spinelli M, Giardiello G, Arduini A et al. New percutaneous technique of sacral nerve stimulation has high initial success rate: preliminary results. Eur Urol 2003; 43: 70-74
  • 44 Bosch JL, Groen J. Sacral nerve neuromodulation in the treatment of patients with refractory motor urge incontinence: long-term results of a prospective longitudinal study. J Urol 2000; 163: 1219-1222
  • 45 Ganio E, Masin A, Ratto C et al. Short-term sacral nerve stimulation for functional anorectal and urinary disturbances: results in 40 patients: evaluation of a new option for anorectal functional disorders. Dis Colon Rectum 2001; 44: 1261-1267
  • 46 Leroi AM, Michot F, Grise P et al. Effect of sacral nerve stimulation in patients with fecal and urinary incontinence. Dis Colon Rectum 2001; 44: 779-789
  • 47 Goos M, Ruf G, Jargon D et al. CT gesteuerte Elektrodenplazierung zur Sakralnervenstimulation bei Stuhlinkontinenz (cSNS). Zentralbl Chir 2012; (accepted for publication)
  • 48 Dudding TC, Pares D, Vaizey CJ et al. Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: a 10-year cohort analysis. Colorectal Dis 2008; 10: 249-256
  • 49 Gourcerol GMD, Gallas SMD, Michot FP et al. Sacral nerve stimulation in fecal incontinence: are there factors associated with success?. Dis Colon Rectum 2007; 50: 3-12
  • 50 Munoz-Duyos A, Navarro-Luna A, Brosa M et al. Clinical and cost effectiveness of sacral nerve stimulation for faecal incontinence. Br J Surg 2008; 95: 1037-1043
  • 51 Bannowsky A, Wefer B, Braun PM et al. Urodynamic changes and response rates in patients treated with permanent electrodes compared to conventional wire electrodes in the peripheral nerve evaluation test. World J Urol 2008; 26: 623-626
  • 52 Janknegt RA, Weil EHJ, Eerdmans PHA. Improving neuromodulation technique for refractory voiding dysfunctions: Two-stage implant. Urology 1997; 49: 358-362
  • 53 Borawski KM, Foster RT, Webster GD et al. Predicting implantation with a neuromodulator using two different test stimulation techniques: A prospective randomized study in urge incontinent women. Neurourol Urodyn 2007; 26: 14-18
  • 54 Melenhorst J, Koch SM, Uludag O et al. Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantations. Colorectal Dis 2007; 9: 725-730
  • 55 Michelsen HB, Buntzen S, Krogh K et al. Rectal volume tolerability and anal pressures in patients with fecal incontinence treated with sacral nerve stimulation. Dis Colon Rectum 2006; 49: 1039-1044
  • 56 Altomare DF, Rinaldi M, Petrolino M et al. Permanent sacral nerve modulation for fecal incontinence and associated urinary disturbances. Int J Colorectal Dis 2004; 19: 203-209
  • 57 Mowatt G, Glazener C, Jarrett M. Sacral nerve stimulation for faecal incontinence and constipation in adults. Cochrane Database Syst Rev 2007; (3) CD004464
  • 58 Matzel KE, Lux P, Heuer S et al. Sacral nerve stimulation for faecal incontinence: long-term outcome. Colorectal Dis 2009; 11: 636-641
  • 59 Matzel KE, Kamm MA, Stosser M et al. Sacral spinal nerve stimulation for faecal incontinence: multicentre study. Lancet 2004; 363: 1270-1276
  • 60 Altomare DFM, Ratto CMD, Ganio EMD et al. Long-term outcome of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 2009; 52: 11-17
  • 61 Mellgren A, Wexner SD, Coller JA et al. Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 2011; 54: 1065-1075
  • 62 George AT, Kalmar K, Panarese A et al. Long-term outcomes of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 2012; 55: 302-306
  • 63 Conaghan P, Farouk R. Sacral nerve stimulation can be successful in patients with ultrasound evidence of external anal sphincter disruption. Dis Colon Rectum 2005; 48: 1610-1614
  • 64 Chan MK, Tjandra JJ. Sacral nerve stimulation for fecal incontinence: external anal sphincter defect vs. intact anal sphincter. Dis Colon Rectum 2008; 51: 1015-1025
  • 65 Malouf AJ, Vaizey CJ, Nicholls RJ et al. Permanent sacral nerve stimulation for fecal incontinence. Ann Surg 2000; 232: 143-148
  • 66 Boyle DJ, Knowles CH, Lunniss PJ et al. Efficacy of sacral nerve stimulation for fecal incontinence in patients with anal sphincter defects. Dis Colon Rectum 2009; 52: 1234-1239
  • 67 Melenhorst J, Koch SM, Uludag O et al. Is a morphologically intact anal sphincter necessary for success with sacral nerve modulation in patients with faecal incontinence?. Colorectal Dis 2008; 10: 257-262
  • 68 Jarrett ME, Dudding TC, Nicholls RJ et al. Sacral nerve stimulation for fecal incontinence related to obstetric anal sphincter damage. Dis Colon Rectum 2008; 51: 531-537
  • 69 Jarrett ME, Matzel KE, Christiansen J et al. Sacral nerve stimulation for faecal incontinence in patients with previous partial spinal injury including disc prolapse. Br J Surg 2005; 92: 734-739
  • 70 Gstaltner K, Rosen H, Hufgard J et al. Sacral nerve stimulation as an option for the treatment of faecal incontinence in patients suffering from cauda equina syndrome. Spinal Cord 2008; 46: 644-647
  • 71 Holzer B, Rosen HR, Novi G et al. Sacral nerve stimulation for neurogenic faecal incontinence. Br J Surg 2007; 94: 749-753
  • 72 deMiguel M, Oteiza F, Ciga MA et al. Sacral nerve stimulation for the treatment of faecal incontinence following low anterior resection for rectal cancer. Colorectal Dis 2011; 13: 72-77
  • 73 Holzer B, Rosen HR, Zaglmaier W et al. Sacral nerve stimulation in patients after rectal resection – preliminary report. J Gastrointest Surg 2008; 12: 921-925
  • 74 Jarrett ME, Matzel KE, Stosser M et al. Sacral nerve stimulation for fecal incontinence following surgery for rectal prolapse repair: a multicenter study. Dis Colon Rectum 2005; 48: 1243-1248
  • 75 Jarrett ME, Matzel KE, Stosser M et al. Sacral nerve stimulation for faecal incontinence following a rectosigmoid resection for colorectal cancer. Int J Colorectal Dis 2005; 20: 446-451
  • 76 Boenicke L, Kim M, Reibetanz J et al. Stapled transanal rectal resection and sacral nerve stimulation – impact on faecal incontinence and quality of life. Colorectal Dis 2012; 14: 480-489
  • 77 Yakovlev A, Karasev SA, Dolgich OY. Sacral nerve stimulation: a novel treatment of chronic anal fissure. Dis Colon Rectum 2011; 54: 324-327
  • 78 Dudding TC, Vaizey CJ, Jarrett ME et al. Permanent sacral nerve stimulation for treatment of functional anorectal pain: report of a case. Dis Colon Rectum 2007; 50: 1275-1278
  • 79 Falletto E, Masin A, Lolli P et al. on behalf of the GINS (Italian Group for Sacral Neuromodulation). Is sacral nerve stimulation an effective treatment for chronic idiopathic anal pain?. Dis Colon Rectum 2009; 52: 456-462