What is Bowel Incontinence?
Bowel incontinence is leakage of some kind from the bowel, or uncontrollable gas or flatulence that isn't caused by a one-time incident or infection and is repeated or continuous over an extended period of time.
Some people have symptoms such as a little bit staining of their underwear from time to time. Some people pass a lot of gas without knowing. Others find themselves urgently running for the toilet. Some people are careful to ensure that they know where the toilets are when they go out. This is called toilet mapping. Some people need to wear continence aids, such as absorbent pads.
What is the treatment for Bowel Incontinence?
Sacral nerve stimulation (SNS) is a treatment option, initially developed for people suffering with urinary incontinence. It has since been found to be useful in fecal incontinence and also constipation.
Sacral nerve stimulation involves the placement of an electrode through one of the naturally-occurring holes in the sacrum. The electrode lies alongside the sacral nerves. These nerves supply the organs in the pelvis and the pelvic floor muscles. Regular, gentle pulses of electricity are passed along the electrode from a battery pack. Sacral nerve stimulation (SNS) is not effective for everyone. We therefore do a two week test stimulation, to see if it will be of benefit to the patient. The test stimulation involves having the electrode inserted in a hospital setting. This is carried can be done under local anesthetic.
If the test period of sacral nerve stimulation is successful, the patient will be asked to come in for insertion of the permanent implant. This is also generally done as a day case, but usually involves a general anesthetic. In the case of a permanent implant, an electrode and battery box are all implanted under the skin. The battery box is very similar to a pacemaker used for heart patients, and is placed into the fat tissue over your buttock. The lead that we use for the implant has four electrodes along the tip, allowing us to give more localized stimulation of the appropriate nerves. It also has little plastic barbs on it, called tines, which help to keep it in place and reduce movement of the lead.