Reframing loss of efficacy in sacral neuromodulation: a neurofunctional service model for coloproctology - Takeaways - MDSpire
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Addressing the Decline in Effectiveness of Sacral Neuromodulation: A Neurofunctional Approach in Coloproctology

  • By

  • E. Ram

  • D. Carter

  • June 2, 2026

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  • 1

    Sacral neuromodulation (SNM) is used for fecal incontinence, low anterior resection syndrome, and bowel dysfunction, but faces challenges like variability in response and loss of efficacy.

  • 2

    Loss of efficacy (LOE) in SNM is defined as deterioration after initial benefit, requiring specific conditions to be met for clinical relevance.

  • 3

    Functional LOE occurs despite intact hardware, necessitating reassessment before considering device revision or explantation.

  • 4

    Neuroadaptive drift and phenotype mismatch are proposed hypotheses explaining reduced response to SNM over time, highlighting the need for ongoing evaluation.

  • 5

    The paper focuses on coloproctological SNM practice, particularly for fecal incontinence and low anterior resection syndrome, excluding certain constipation phenotypes.

Original Source(s)

Reframing loss of efficacy in sacral neuromodulation: a neurofunctional service model for coloproctology

  • by E. Ram, D. Carter

  • June 2, 2026

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