Abstract Purpose After implantation of the sacral nerve modulation (SNM) for faecal incontinence (FI), patients are subjected to a rigid follow-up schedule. In case of symptom recurrence, reprogramming of stimulation parameters may be necessary. The purpose of this study was to assess the need for reprogramming in patients with SNM for FI. Methods All patients from January 2000 till February 2008 with a permanent SNM for FI were analysed. Patients were subjected to a rigid follow-up schedule at 1 month, 3 months, 6 months, 12 months and yearly thereafter. SNM stimulator settings and changes at every.visit were collected and added to the database. Also, the number of patients that needed parameter setting reprogramming were analysed. Results 155 patients (11 males) were analysed. Mean age was 57.7 +/- 11.9 years. Median follow-up was 28.1 months (range 1.0-93.6). The mean voltage increased significantly from 1.8V at 1 month to 2.0V at 3 months. 39 patients (25.2%) required no reprogramming in any follow-up visits while 51 patients (32.9%) required reprogramming at 1 to 25% of their visits, 42 patients (27.1%) at 26 to 50% of the visits, 14 (9.0%) patients at 51 to 75% of the visits, and 9 (5.8%) patients at 76 to 100% of the visits. Conclusions Physicians and patients need to be aware of the fact that reprogramming of the SNM stimulator needs to be done at least once during follow-up in the majority of all patients. Trained physicians or specialist nurses are imperative for correct patient follow-up and SNM reprogramming.