Faecal Incontinence & Sacral Nerve Stimulation

Faecal incontinence describes the involuntary loss of stool or difficulty controlling the bowel. It can range from occasional urgency through to more troubling loss of control. Causes are often multifactorial and include obstetric injury, prior surgery, neurological conditions and changes with age.

Assessment begins with a careful history and examination, followed by targeted investigations. These may include anorectal physiology testing, endoanal ultrasound and, where relevant, colonoscopy. The aim is to understand the specific contributors so that treatment can be matched to the cause.

Sacral nerve stimulation, also known as sacral neuromodulation, is a well-established treatment for faecal incontinence that has not responded to conservative measures. A fine electrode is positioned near the sacral nerves and connected to a small implanted stimulator to modulate bowel function. The approach to implantation is tailored to the individual and discussed in detail beforehand.

Sacral nerve stimulation is most appropriate for patients with persistent symptoms despite optimised conservative management, including dietary adjustment, medication and pelvic floor physiotherapy. Suitability is established through clinical assessment and physiological testing.

• Dietary and lifestyle measures.
• Medication to modify stool consistency.
• Pelvic floor physiotherapy and biofeedback.
• Sacral nerve stimulation (sacral neuromodulation).
• Selected surgical procedures where indicated.

Many patients experience meaningful improvement in symptoms and quality of life. With sacral nerve stimulation, the device settings can be adjusted over time to suit your response, and the device can be removed if required.