Sakral nervstimulering ger bra effekt vid anal inkontinens. Indikationsområdena för detta minimalinvasiva ingrepp vidgas alltmer
Engelsk titel: Sacral nerve stimulation effective in anal incontinence. Indications for this minimally invasive intervention more and more extended
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Författare:
Graf, Wilhelm
;
Karlbom, Urban
Email: wilhelm.graf@akademiska.se
Språk: Swe
Antal referenser: 26
Dokumenttyp:
Översikt
UI-nummer: 10031616
Sammanfattning
Sacral nerve stimulation is used for treatment of severe faecal incontinence. Treatment involves stimulation of the second, third or fourth sacral nerve root through the sacral foramina, initially with a test electrode connected to an external stimulator during a three-week period. Successful test stimulation is defined as a 50 percent reduction of incontinence episodes. If successful, a permanent electrode is inserted in a second operation and connected to an implanted stimulator. Stimulation should be preceded by a period of conservative treatment and a thorough evaluation in order to rule out secondary causes of incontinence. With proper patient selection, successful results can be expected in about 75 percent of permanent implantations. Patients with a significant sphincter injury should usually be offered a sphincter reconstruction before sacral nerve stimulation is attempted. Preliminary studies suggest that sacral nerve stimulation can also provide symptom relief in patients with chronic constipation, perineal pain and irritable bowel syndrome, but these data need to be confirmed in controlled trials.