Invited comment on Hultén et al.: Sacral nerve stimulation (SNS), posterior tibial nerve stimulation (PTNS) or acupuncture for the treatment for fecal incontinence: A clinical commentary

摘要

We thank Prof. L. Hulten for his critical contribution on sacral nerve stimulation (SNS) for the treatment of fecal incontinence (FI) [1]. He reports the conclusions of the Swedish HTA about the doubtful efficacy, complications and costs of this procedure, and describes some "new," more cost-effective and promising procedures for the same indication, like posterior tibial nerve stimulation (PTNS) and acupuncture (ACU).A realistic and critical point of view on every aspect of "new technologies" used in medicine is always mandatory to evaluate the real efficacy and complication rate, in particular because more technologically advanced devices usually mean higher costs, and this could be a very important factor in the difficult economic situation that we are facing. It is without doubt worthwhile to gain further knowledge about new therapy options; however, treatment decisions and recommendations should be based on available clinical evidence and follow clinical guidelines when appropriate.