Outcomes of rechargeable sacral neuromodulation for faecal incontinence: A single-centre observational study.

Abstract

Faecal incontinence (FI) remains a debilitating condition with considerable psychosocial burden. Rechargeable sacral neuromodulation (rSNM) systems offer extended battery longevity and MRI compatibility, potentially reducing surgical burden. However, real-world data on their efficacy, safety and acceptability remain limited. This single-centre observational cohort study evaluated 37 patients who received rSNM (InterStim™ Micro) for FI between August 2020 and August 2022. Patients completed validated questionnaires (St Mark's FI Score, Rockwood FIQOL, SF-36) and a structured telephone interview assessing functional outcomes, adverse events and device satisfaction. Clinical records were reviewed for surgical and 3- to 5-year follow-up data. Median age was 63 years; 61% had a history of obstetric injury. Twenty-eight patients received rSNM as a replacement for non-rechargeable systems. Device satisfaction was low: 62% expressed regret and 96% reported challenges with charging. Connectivity issues affected 86% of patients. Six patients underwent device explantation and two required lead revision. Rockwood FIQOL and SF-36 scores indicated persistent impairment in lifestyle, emotional well-being and social functioning. Improvements in continence scores were modest and below expectations. Despite theoretical advantages, rSNM provided limited clinical benefit in this cohort. High rates of dissatisfaction, management difficulties and surgical revisions raise concerns about its broader applicability. While the smaller device may suit select patients, non-rechargeable systems with extended battery life may represent a more acceptable first-line option. Further studies are needed to better define the role of rSNM in FI management.