InterStim, or sacral nerve stimulation is stimulation of the third sacral nerve root to improve bowel control. The same technique has been approved by the FDA for use by our urology colleagues for management of urinary incontinence since 1997. Sacral nerve stimulation has been available in Europe and Canada for the treatment of fecal incontinence for years, but only in the second half of 2011 gained FDA approval.
In a recent study of 132 patients with fecal incontinence greater than or equal to twice weekly, InterStim was able to reduce the number of episodes by at least 50% in 83%. Another 41% of patients reported complete continence. Test stimulation was performed over two weeks using a chronic implant lead, to determine probable success of sacral nerve stimulation. Successful test stimulation, defined as a > 50% reduction in their symptoms, was required before permanent implantation with InterStim. If the test stimulation was not successful, the test lead was simply removed. The most common adverse events included pain at the implant site, numbness and tingling, and implant site infection.