{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T10:44:55Z","timestamp":1755600295840},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2009,6,15]],"date-time":"2009-06-15T00:00:00Z","timestamp":1245024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sacral nerve stimulation (SNS) is an effective treatment for faecal incontinence, but only standard stimulation parameters have been used. This study assessed the clinical impact of altering the parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Twelve patients with partially improved faecal incontinence following SNS underwent acute testing to select optimal stimulation parameters; rectal compliance was used as a surrogate marker. Parameters tested were: stimulation off; frequency 14 (standard), 31 or 6\u00b79 Hz; and pulse duration 210 (standard), 450 or 90 \u00b5s. Patients completed a 2-week bowel diary, St Mark's continence score (SMCS) and Rockwood faecal incontinence quality-of-life (FIQL) score before testing using standard settings, and after testing using optimized settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Optimal settings, determined by greatest increase in rectal compliance, were shorter pulse width in five patients and higher frequency in seven. Optimized stimulation resulted in a decrease in mean episodes of incontinence from 2\u00b73 to 1\u00b72 per week (P = 0\u00b7031), soiling from 3\u00b73 to 1\u00b77 days per week (P = 0\u00b7016), faecal urgency from 31 to 18 per cent of all evacuations (P = 0\u00b7055) and SMCS from 12\u00b73 to 8\u00b77 (P = 0\u00b7008); the FIQL coping\/behaviour score improved (P = 0\u00b7008).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>With a shorter pulse width and higher frequency, clinical efficacy in patients undergoing SNS for faecal incontinence can be improved.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6637","type":"journal-article","created":{"date-parts":[[2009,6,15]],"date-time":"2009-06-15T18:56:48Z","timestamp":1245092208000},"page":"778-784","source":"Crossref","is-referenced-by-count":44,"title":["Improving the efficacy of sacral nerve stimulation for faecal 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