Skip Navigation

Sacral nerve stimulation for faecal incontinence

Guidance issued Guidance issued
 
IP Guidance Number: IPG99
 
Summary:

NICE issued full guidance on this procedure to the NHS in England, Wales, Scotland and Northern Ireland in August 2003 on sacral nerve stimulation for faecal incontinence. It included a statement saying that the procedure would be reconsidered pending the results of a systematic review to be commissioned by NICE. The Interventional Procedures Advisory Committee (IPAC) have reviewed the results of the systematic review and NICE has issued revised full guidance in October 2004 - IPG099. This revised guidance replaces and updates the previous guidance IPG05.

Description:

Faecal incontinence occurs when a patient loses control over the passing of faeces from the rectum to the outside of the body. Faecal incontinence may result from degeneration of the anal sphincter, spinal injury or other neurologic disorders.

Faecal incontinence is associated with a high level of physical and social disability. If left untreated, the patient may end up wearing pads to control the condition. Faecal incontinence is the second leading cause of admission to long-term care facilities in the United States.

In patients with a weak but structurally intact sphincter it may be possible to alter sphincter and proximal bowel behaviour using the surrounding nerves and muscles. Sacral nerve stimulation is a treatment option for these patients. It involves low-level electrical stimulation applied via electrodes through the sacral foramina to the sacral nerve supply of the lower bowel and sphincters. Shortly after surgery continuous stimulation begins. The patient interrupts the pulse for defaecation and voiding, using an external magnet.

Arrangements:

Other (see guidance)

Topic Area:

Central nervous system
Digestive system

Specialty:

Gastro-enterology
General surgery

Specialist advice has
been sought from:

Association of Coloproctology of Great Britain and Ireland

Society of British Neurological Surgeons

Date notified to NICE: 01 April 2002
Guidance Publication Date: 24 November 2004
Contact Details:
Project Manager
(for general enquiries or comments)
Ben Doak
ip@nice.org.uk
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA


Links:

Search NICE guidance


Advanced guidance search

Related guidance

Click the links below to see guidance on similar topics