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Evidence summaries

Sacral Nerve Stimulation for Faecal Incontinence and Constipation in Adults

Level of evidence: "A"

A Cochrane review [Abstract] 1 included 4 studies with a total of 260 subjects. Findings from one trial suggested that electrical stimulation with anal biofeedback and exercises provided more short-term benefits than vaginal biofeedback and exercises for women with obstetric-related faecal incontinence. At the 12-week assessment there was a significant difference in favour of the electrical stimulation group in respect of the number of people who became asymptomatic (RR 0.40 95% CI 0.17 to 0.91) or improved (RR 0.06 95% CI 0.00 to 0.91) in their incontinence status, but this study had serious methodological flaws. Another study found contradictory results, with no added benefit from electrical stimulation over biofeedback and exercises alone. Although all trials reported that patient's symptoms were generally improved, it is not clear that this was the effect of electrical stimulation. No further conclusions could be drawn from the data available.

Comment: The quality of evidence is downgraded by study quality (inadequate follow up, no no-treatment group included), by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (few patients and wide confidence intervals).

    References

    • Hosker G, Cody JD, Norton CC. Electrical stimulation for faecal incontinence in adults. Cochrane Database Syst Rev 2007 Jul 18;(3):CD001310. [PubMed]

Primary/Secondary Keywords