Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 501

Sacral nerve stimulation (SNS), also known as sacral neuromodulation, was first described in 1995.⁶⁶ Although the mechanism of action is not completely understood, electrical stimulation of the sacral nerve via an implanted generator and electrode (normally in the S3 foramen) increases the resting tone of the anus and, therefore, reduces incontinence.⁶⁷ Multiple small case series in selected patients have shown benefit; a Cochrane Review identified six crossover trials, concluding that the limited available evidence suggests that SNS can improve continence in a portion of patients with faecal incontinence. The largest randomized trial included 120 patients, 60 receiving SNS and 60 control, with ages ranging from 39 to 86 and a mean age of 63.5. With sacral nerve stimulation, incontinent episodes per week decreased from an average of 9.5 to 3.1, and mean incontinent days per week from 3.3 to 1. Complete continence was accomplished in 25 patients. There was no improvement in the control group at 12 months.⁶⁸