{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:15:58Z","timestamp":1791954958721,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anal sphincteroplasty (AS) was considered standard treatment for fecal incontinence (FI) associated with sphincter injury; however, long\u2010term outcomes have been disappointing. Sacral neuromodulation (SNM) has proven effective for FI secondary to anal sphincter defects. This review aimed to assess outcomes of SNM in FI associated with anal sphincter defects and to compare outcomes to AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A PRISMA\u2010compliant systematic review inquired PubMed and Scopus through January 2025 for studies that assessed SNM in FI secondary to anal sphincter defects. The primary outcome was continence improvement and change in baseline incontinence scores; overall complications were the secondary outcome. Random\u2010effect meta\u2010analyses were used to calculate pooled outcomes and odds of continence improvement after SNM compared to AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies incorporating 779 patients (93.9% female; median age 54.5\u00a0years) were included. SNM was performed in 503 (64.5%) and AS in 265 (34%) patients. The weighted mean reduction in incontinence scores after SNM was 8.53 points (95% CI: 6.11, 10.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and the pooled rate of continence improvement was 66.7% (95% CI: 52.2%\u201381.1%). Previous sphincteroplasty, external sphincter defects &gt;\u00a0120\u00b0, and low resting anal pressure were significantly associated with less continence improvement. Pooled complication and device removal rates were 18.5% (95% CI: 8.7%\u201328.2%) and 9.1% (95% CI: 3.4%\u201314.7%), respectively. SNM was associated with better continence improvement than AS (OR: 1.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.006) with similar odds of complications (OR: 0.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.763).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SNM was associated with a good improvement in FI associated with anal sphincter defects. However, a longer follow\u2010up is required to ascertain these mid\u2010term outcomes. There are not enough data to date to draw solid conclusions regarding the comparison between SNM and sphincteroplasty in patients with sphincter lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70152","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T08:08:48Z","timestamp":1763798928000},"page":"48-57","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of Sacral Neuromodulation in Treatment of Fecal Incontinence Associated With Anal Sphincter Defects: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"50","author":[{"given":"Sameh Hany","family":"Emile","sequence":"first","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Colorectal Surgery Unit General Surgery Department Mansoura University Hospitals  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjelli","family":"Wignakumar","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Horesh","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Garoufalia","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Oosenbrug","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Department of Colorectal Surgery MedStar Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Strassmann","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-5753","authenticated-orcid":false,"given":"Steven D.","family":"Wexner","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Department of Colorectal Surgery MedStar Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.18043\/ncm.77.3.211"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0b013e31828016d3"},{"key":"e_1_2_10_4_1","article-title":"The Orchestra of Anal Continence: How Can It Affect the Management Decision","volume":"6","author":"Emile S. 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