[Sacral neuromodulation in fecal incontinence. A pilot prospective experience in Argentina].

INTRODUCTION: Anal incontinence is a severe physical and emotional condition that affects quality of life. Its treatment with neuromodulation, that consists in sacral roots electrical stimulation, has became a therapeutic option.

OBJECTIVE: This study was designed to present the surgical technique and the first prospective experience in neuromodulation for fecal incontinence in Argentina.

PATIENTS AND METHODS: Four females with severe fecal incontinence (mean score 17/20) were included. Anorectal physiology testing and anal ultrasound were performed before surgery. Due to failed medical treatment and the presence of an intact anal sphincter, sacral neuromodulation was indicated. After temporary sacral nerve evaluation, definitive neuromodulator was implanted.

RESULTS: After 13 months the incontinence score and the number of weekly escapes decrese from 17/20 to 1.7/20 (p = 0.059) and from 62 to 0.2 (p = 0.059). Quality of life scores also improves but not statiscally significative.

CONCLUSIONS: Sacral neuromodulation in fecal incontinence is useful. It is effective in patients who had failed maximum conservative therapies with the advantage of testing before definitive.