Sacral Nerve Neuromodulation for the Treatment of Patient
with Idiopathic Fecal Incontinence: A First Successful
Case Report: in Thailand
Boonnithi W, MD¹, Parakonthun T, MD¹, Riansuwan W, MD¹, Lohsiriwat V, MD, PhD¹, Lindsey I, MD²,
Prapasrivorakul S, MD¹
Affiliation : ¹ Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ² Department of Colorectal Surgery, Oxford Pelvic Floor Centre, Oxford University Hospitals, Oxford, UK
Fecal incontinence is a debilitating condition that significantly impacts on psychosocial aspect and quality of life. Several
treatment modalities have been used with various outcomes. Sacral nerve neuromodulation or stimulation (SNS) has been
reported as an effective treatment for fecal incontinence in many countries. However, it is a novel procedure in Thailand. The
authors herein reported a successful outcome of SNS in a Thai patient suffering from idiopathic fecal incontinence. The case
report was a 57-year-old female presenting with passive and urge fecal incontinence for three years. Endoanal ultrasonography
and magnetic resonance imaging (MRI) defecography demonstrated no anatomical abnormalities. Anorectal manometry revealed
low baseline anorectal sphincter pressure with anismus. Preoperative St. Mark’s incontinence score and gastrointestinal quality
of life (GIQoL) was 20 and 98, respectively. Two-stage sacral nerve stimulation was performed. A pulse generator was implanted
two weeks after a successful testing (50% symptom improvement). Postoperative period was uneventful. At a 6-month follow-up,
her incontinence significantly improved with St. Mark’s incontinence score of 6 and GIQoL score of 126.
Keywords : Fecal incontinence, Outcome, Sacral nerve neuromodulation, Sacral nerve stimulation
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