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Sacral nerve stimulation (SNS), posterior tibial nerve stimulation (PTNS) or acupuncture for the treatment for fecal incontinence: a clinical commentary.

Journal article
Authors Leif Hultén
Ulf Angerås
M Scaglia
D Delbro
Published in Techniques in coloproctology
Volume 17
Issue 5
Pages 589-92
ISSN 1128-045X
Publication year 2013
Published at
Pages 589-92
Language en
Links dx.doi.org/10.1007/s10151-013-0985-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Acupuncture Therapy, methods, Electric Stimulation Therapy, methods, Fecal Incontinence, diagnosis, therapy, Female, Humans, Lumbosacral Plexus, Male, Prognosis, Quality of Life, Risk Assessment, Severity of Illness Index, Tibial Nerve, Treatment Outcome
Subject categories Surgery

Abstract

Sacral nerve stimulation (SNS) has become an established therapy worldwide for the treatment for fecal incontinence. A large number of papers have been published over the years, and SNS is generally considered very effective with improved continence and quality of life for most patients. However, the results are mostly expressed in the semi-quantitative terms, that is, patients' diaries translated into score points. The clinical value of SNS is questionable, especially as the patient groups are usually small and/or etiologically heterogenic and the follow-up period mostly short. The Health Technology Assessment organization in the west region of Sweden has recently evaluated the SNS with regard to evidence, efficacy and risks. Economic and ethical aspects raise serious questions on this expensive and not entirely risk-free treatment in routine medical care. Similar criticism has also been raised by other reviewers proposing a more thorough scientific assessment with well-designed randomized trials and comparison with other similar methods of treatment.

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