Sammanfattning
Background. Sacral nerve stimulation involves electrical stimulation of a sacral nerve root by means of an electrode and a stimulator. In the course of just a few years, sacral nerve stimulation has become a treatment option for selected patients with urinary retention, urinary incontinence, anal incontinence and constipation. The method is also being tested in connection with several other indications.
Material and methods. The article presents the method and reviews the results of treatment in connection with various indications on the basis of the authors’ own experience and after a non-systematic PubMed search.
Results. An external stimulator is used during a test period of 3 - 30 days, depending on the indication. A positive test (improvement of symptoms by 50 % or more) is achieved by 70 - 90 % of patients with anal incontinence, 70 % with non-obstructive urinary retention, 52 - 77 % with urinary urge incontinence and 43 - 72 % with constipation. Sacral nerve stimulation may also be efficacious in patients with chronic pelvic pain. Following implantation of a stimulator a sustained effect is seen in 50 - 90 % of patients with a positive test response. Up to 75 % of patients will need repeated follow-up in the form of stimulator reprogramming or reoperation due to technical failure. The service life of the stimulator is 3 - 10 years, and it must be replaced surgically when the battery wears out.
Interpretation. Treatment with sacral nerve stimulation may have a sustained effect in patients with various pelvic floor dysfunctions, and appears to be especially efficacious in cases of anal incontinence and non-obstructive urinary retention. Most of the patients will need close follow-up in order to maintain an optimal result.