Peripheral neuromodulation via posterior tibial nerve stimulation - a potential treatment for faecal incontinence?

Annals of the Royal College of Surgeons of England
John FindlayCharles Maxwell-Armstrong

Abstract

Faecal incontinence is a prevalent and important condition, with a range of treatment options. Neuromodulation via sacral nerve stimulators is efficacious, but expensive and associated with complications due to device implantation. Peripheral neuromodulation via posterior tibial nerve stimulation (PTNS) has been assessed in urinary incontinence, but there is minimal evidence for its use in faecal incontinence and no literature from the UK. This retrospective review aimed to assess the efficacy of PTNS in faecal incontinence. Thirteen consecutive female patients with faecal incontinence of various causes (9 idiopathic, 3 obstetric, 1 surgery) underwent PTNS at a UK hospital. All were investigated with colonic imaging, anorectal physiology and endo-anal ultrasound. Prior treatments included physiotherapy (13), sphincteroplasty (3) biofeedback (3) and PTQ implants (1). PTNS was performed for 30 min, weekly for 12 weeks. Median monthly episodes of incontinence of wind, liquid and solid reduced from 6, 10 and 18 respectively to 0 with 12 weeks' treatment (P < 0.05). Significant improvements in quality of life indices were also seen. At 1-month follow up, a sustained reduction in incontinence of wind was seen (0 episodes), with non-s...Continue Reading

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Citations

Nov 28, 2013·Nature Reviews. Gastroenterology & Hepatology·Peter J Mitchell, Peter M Sagar
Jan 11, 2014·World Journal of Gastroenterology : WJG·Anil Thomas GeorgeCharles Maxwell-Armstrong
Nov 12, 2010·International Journal of Colorectal Disease·John M Findlay, Charles Maxwell-Armstrong
Jan 19, 2013·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·A J Kroesen
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