Sacral nerve stimulation can improve continence in patients with Crohn's disease with internal and external anal sphincter disruption

PURPOSE: Sacral nerve stimulation is a technique commonly used for the treatment of idiopathic incontinence. This study was designed to assess the efficiency of sacral nerve stimulation as a means of treating fecal incontinence in patients with Crohn's disease with disrupted internal and external anal sphincters. METHODS: Five patients (3 women) with fecal incontinence suffering from Crohn's disease-related anoperineal lesions were treated by applying three weeks of sacral nerve stimulation and then by permanent sacral nerve stimulation implantation. Endoanal ultrasonography showed that all of these patients had disrupted external and internal anal sphincters. RESULTS: Continence was improved in all treated patients. The median follow-up time was 14 (range, 3-36) months. At the end of the follow-up period, the median Wexner's score significantly improved from 15 to 6 and the median number of daily stools decreased from 7 to 2. The patients' quality of life also increased significantly. CONCLUSIONS: Sacral nerve stimulation improves fecal continence in patients suffering from Crohn's anoperineal lesions with internal and external anal sphincters disruption.