ABSTRACT
The use of sacral nerve stimulation as a treatment for fecal incontinence for intact
but functionally deficient sphincter and pelvic floor musculature, as well as for
some sphincter injuries, is an attractive concept that is currently undergoing clinical
trials in the United States. Electrical stimulation of the peripheral nerve supply
to the striated anal sphincter muscles at the level of the sacral spinal nerves exploits
the accessibility of the most distal common location of the dual peripheral nerve
supply to these muscles. While the mechanism of sacral nerve stimulation's salutary
effect remains conjectural at present and is likely multifactorial, current experimental
data point toward both an enhancement in striated muscular activity as well as neuromodulation
of sacral reflexes that regulate rectal sensitivity and contractility.
KEYWORDS
Fecal incontinence - sacral nerve stimulation - anal sphincter muscles
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David A MargolinM.D.
Department of Colon and Rectal Surgery, Ochsner Clinic Foundation
1514 Jefferson Hwy., New Orleans, LA 70121
eMail: damargolin@ochsner.org