Sacral nerve stimulation for constipation

Background: For over 10 years sacral nerve stimulation (SNS) has been used for patients with constipation resistant to conservative treatment. A review of the literature is presented.

Methods: PubMed, MEDLINE and Embase databases were searched for studies demonstrating the use of SNS for the treatment of constipation.

Results: Thirteen studies have been published describing the results of SNS for chronic constipation. Of these, three were in children and ten in adults. Test stimulation was successful in 42-100 per cent of patients. In those who proceeded to permanent SNS, up to 87 per cent showed an improvement in symptoms at a median follow-up of 28 months. The success of stimulation varied depending on the outcome measure being used. Symptom improvement correlated with improvement in quality of life and patient satisfaction scores.

Conclusion: SNS appears to be an effective treatment for constipation, but this needs to be confirmed in larger prospective studies with longer follow-up. Improved outcome measures need to be adopted given the multiple symptoms that constipation may be associated with. Comparison with other established surgical therapies also needs consideration.