Sacral Nerve Stimulation for Low Anterior Resection Syndrome

The American Gastroenterological Association indicates that sacral nerve stimulation is medically indicated for patients with low anterior resection syndrome that has been refractory to conservative measures 1
The American Gastroenterological Association recommends evaluating patients for SNS candidacy if they are experiencing difficulty with bowel management following low anterior resection, and symptoms have persisted despite conservative treatment 1
The American Gastroenterological Association suggests that patients with no contraindications to implantation are suitable candidates for SNS 2
The American Gastroenterological Association advises implementing a two-stage approach, with the first stage involving peripheral nerve evaluation/test stimulation, and proceeding to permanent implantation if successful 2

Potential Complications and Management

The American Gastroenterological Association notes that pain or infection at the insertion site can occur in up to 10% of patients 2
The American Gastroenterological Association states that battery replacement is needed approximately every 7 years 2

The American Gastroenterological Association recommends ongoing medical management with emphasis on suppositories and enemas if SNS fails 3
The American Gastroenterological Association suggests evaluating patients for pelvic floor structural abnormalities if SNS is unsuccessful 3
The American Gastroenterological Association advises managing colonic motor dysfunction with prokinetic agents if SNS fails 3
The American Gastroenterological Association notes that anterograde colonic enema procedures can be considered, although they have lower long-term success rates in adults 3