Sacral nerve electrical stimulation belongs to the category of nerve electrical stimulation. It was first used in the treatment of neurogenic urinary incontinence since the 1940s. Since the 1990s, sacral nerve electrical stimulation has been gradually applied to the treatment of fecal incontinence and constipation, and has achieved good results. Its function is mainly through the stimulation of the sacral nerve, which excites one or several nerves, which can affect the activity of another or several pelvic floor nerves. It is mainly suitable for patients with anorectal neurosis, chronic pelvic floor pain, partial constipation, and fecal incontinence.
In patients with anorectal neurosis and some chronic pelvic floor pain, doctors cannot find organic diseases in clinic. Even anorectal dynamics examination and other X-ray examinations cannot find abnormalities, but patients always feel abnormal paresthesia and various discomforts in the anorectal area , Including ant walking sensation, insect sensation, itching, swelling and dull pain, etc., anal inspection, digital rectal examination, anoscopy or barium enema and defecation contrast intrarectal ultrasound MR, etc., did not have any abnormal findings. A large part of the clinical symptoms are caused by local discomforts in the anorectum, unrestricted exaggeration, fear, and changes in ideas that lead to a vicious circle of worsening clinical symptoms. They are considered to be laxity of the rectal mucosa and rectal protrusion and undergo surgery. The current treatment methods for such patients mainly focus on psychotherapy, and use drugs as appropriate, with little effect.
Shandong Province Anorectal Disease Hospital is now using sacral nerve electrical stimulation to treat patients with the above symptoms, which relieved the pain of the patients and achieved good results. First of all, sacral nerve electrical stimulation is a minimally invasive treatment method that is easy for patients to accept: With the development of science and technology, minimally invasive treatments are increasingly accepted by many patients. Secondly, the operation is simple: our department adopts the nerve stimulator produced by the German Baoya company. The machine is small and fully functional, and the treatment can be started after the nerve stimulation needle and the body surface electrode are punctured. Compared with the cost of surgery, the cost of electrical stimulation is low, and the position of transsacral nerve electrical stimulation is accurately fixed, which is not easy to damage the nerve function of other parts, and the effect is satisfactory.
Due to sacral nerve stimulation, the nerve fibers of the left 1/3 transverse colon, descending colon, and rectum-anal canal can be stimulated, leading to rectal contraction and defecation in some patients, shortening the defecation time; improving sigmoid colon peristalsis, reducing the occurrence of constipation and low voltage. Training the strength of the external sphincter without causing detrusor contraction is helpful to improve the stress urinary incontinence when the abdominal pressure increases; it leads to the increase of the strength of the pelvic floor and sphincter and corrects the inappropriate relaxation of the pelvic floor. Patients with incontinence are also treated with sacral nerve electrical stimulation, which also achieves good results in the initial stage.
Li A young woman was admitted to the hospital with "pelvic floor muscle spasm and constipation" at the outpatient clinic for 3 years due to difficulty in defecation and incomplete defecation after anal fissure operation on February 4, 2012. Specialist examination: Lithotomy position, digital examination: local tenderness and no volatility at 11 o'clock in the finger 3cm, no pus, blood and mucus in the withdrawal of the finger, anal mirror: the surgical incision scar is visible at 7 o'clock, and the healing is good. After admission, the sacral nerve electrical stimulation was performed 3 times a week, and the course of treatment was 4 weeks. After 3 weeks of treatment, the difficulty in defecation and the feeling of incomplete defecation improved significantly.