Guidance
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on sacral nerve stimulation for faecal incontinence.
It replaces the previous guidance on sacral nerve stimulation for faecal incontinence (NICE interventional procedures guidance 5, October 2004) after reviewing the results a systematic review, requested in the original guidance.
Description
Faecal incontinence occurs when a patient loses control over the passing of faeces from the rectum to the outside of the body. Faecal incontinence may result from degeneration of the anal sphincter, spinal injury or other neurologic disorders.
Faecal incontinence is associated with a high level of physical and social disability. If left untreated, the patient may end up wearing pads to control the condition. Faecal incontinence is the second leading cause of admission to long-term care facilities in the United States.
In patients with a weak but structurally intact sphincter it may be possible to alter sphincter and proximal bowel behaviour using the surrounding nerves and muscles. Sacral nerve stimulation is a treatment option for these patients. It involves low-level electrical stimulation applied via electrodes through the sacral foramina to the sacral nerve supply of the lower bowel and sphincters. Shortly after surgery continuous stimulation begins. The patient interrupts the pulse for defaecation and voiding, using an external magnet.
Coding and clinical classification codes for this guidance