Sacral neuromodulation and the low anterior resection syndrome

More than half of patients undergoing a low anterior resection with coloanal anastomosis will experience subsequent bowel dysfunction including symptoms of fecal incontinence and disordered evacuation. This cluster of symptoms is referred to as the low anterior resection syndrome (LARS). Several case series have demonstrated that sacral neuromodulation (SNM) improves various symptoms in individual with LARS, with the greatest degree of improvement in the symptoms of clustering and urgency. Although the mechanism by which SNM therapy was beneficial in a majority of patients with LARS is not clear, SNM warrants serious consideration in application to patients after anterior resection with bowel dysfunction that negatively affects their quality of life.