Abstract
The majority of patients with neuropathic incontinence and other pelvic floor conditions associated with straining at stool have damage to the pudendal nerves (S 2–4) distal to the ischial spine. Electronic searches of the medline (PubMed) database, Cochrane library, and science citation index were performed to identify original published studies on sacral nerve stimulation for bowel dysfunction. Relevant articles were searched from relevant chapters in specialized texts and all included. Sacral nerve stimulation appears to be a promising innovation and will probably be the treatment of choice for neuropathic fecal incontinence and following failed sphincter repair. Newer electrophysiological tests and improved anal endosonography would more effectively guide clinical decision-making. A better understanding of sacral nerve stimulation mechanism of action may explain why the efficacy may diminish with time.
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