Alexander Hotouras BSc, MSc, MBBS(Lon), MRCS(Eng), Academic Surgical Unit, 3rd Floor, Alexandra Wing, The Royal London Hospital, Whitechapel, London E1 1BB, UK.
E-mail: [email protected]

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Abstract

Aim Percutaneous tibial nerve stimulation (PTNS) is increasingly being used as a treatment for faecal incontinence (FI). The evidence for its efficacy is limited to a few studies involving small numbers of patients. The aim of the study was to assess the efficacy of PTNS in patients with urge, passive and mixed FI.

Method A prospective cohort of 100 patients with FI was studied. Continence scores were determined before treatment and following 12 sessions of PTNS using a validated questionnaire [Cleveland Clinic Florida (CCF)-FI score]. The deferment time and average number of weekly incontinence episodes before and after 12 sessions of treatment were estimated from a bowel dairy kept by the patient. Quality of life was assessed prior to and on completion of 12 sessions of PTNS using a validated questionnaire [Rockwood Faecal Incontinence Quality of Life (QoL)].

Results One hundred patients (88 women) of median age of 57 years were included. Patients with urge FI (n = 25) and mixed FI (n = 60) demonstrated a statistically significant improvement in the mean CCF-FI score (11.0 ± 4.1 to 8.3 ± 4.8 and 12.8 ± 3.7 to 9.1 ± 4.4) with an associated improvement in the QoL score. This effect was not observed in patients with purely passive FI (n = 15).

Conclusion The study demonstrates that PTNS benefits patients with urge and mixed FI, at least in the short term.

References

1 Kuehn BM. Silence masks prevalence of fecal incontinence. JAMA 2006; 295: 1362–3.
10.1001/jama.295.12.1362
CAS PubMed Web of Science® Google Scholar
2 Macmillan AK, Merrie AE, Marshall RJ, Parry BR. The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum 2004; 47: 1341–9.
10.1007/s10350-004-0593-0
PubMed Web of Science® Google Scholar
3 Chan CL, Scott SM, Williams NS, Lunniss PJ. Rectal hypersensitivity worsens stool frequency, urgency, and lifestyle in patients with urge fecal incontinence. Dis Colon Rectum 2005; 48: 134–40.
10.1007/s10350-004-0774-x
PubMed Web of Science® Google Scholar
4 Gladman MA, Scott SM, Chan CL, Williams NS, Lunniss PJ. Rectal hyposensitivity: prevalence and clinical impact in patients with intractable constipation and fecal incontinence. Dis Colon Rectum 2003; 46: 238–46.
10.1007/s10350-004-6529-x
PubMed Web of Science® Google Scholar
5 Madoff RD, Parker SC, Varma MG, Lowry AC. Faecal incontinence in adults. Lancet 2004; 364: 621–32.
10.1016/S0140-6736(04)16856-6
PubMed Web of Science® Google Scholar
6 Allison M. Percutaneous tibial nerve stimulation for patients with faecal incontinence. Nurs Stand 2011; 25: 44–8.
10.7748/ns.25.24.44.s51
PubMed Google Scholar
7 Madoff RD. Surgical treatment options for fecal incontinence. Gastroenterology 2004; 126(1 Suppl 1): S48–54.
10.1053/j.gastro.2003.10.015
PubMed Web of Science® Google Scholar
8 Malouf AJ, Vaizey CJ, Norton CS, Kamm MA. Internal anal sphincter augmentation for fecal incontinence using injectable silicone biomaterial. Dis Colon Rectum 2001; 44: 595–600.
10.1007/BF02234337
CAS PubMed Web of Science® Google Scholar
9 Wong WD, Congliosi SM, Spencer MP et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. Dis Colon Rectum 2002; 45: 1139–53.
10.1007/s10350-004-6381-z
PubMed Web of Science® Google Scholar
10 Brazzelli M, Murray A, Fraser C. Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: a systematic review. J Urol 2006; 175(3 Pt 1): 835–41.
10.1016/S0022-5347(05)00326-5
PubMed Web of Science® Google Scholar
11 Boyle DJ, Knowles CH, Lunniss PJ, Scott SM, Williams NS, Gill KA. Efficacy of sacral nerve stimulation for fecal incontinence in patients with anal sphincter defects. Dis Colon Rectum 2009; 52: 1234–9.
10.1007/DCR.0b013e31819f7400
PubMed Web of Science® Google Scholar
12 Boyle DJ, Prosser K, Allison ME, Williams NS, Chan CL. Percutaneous tibial nerve stimulation for the treatment of urge fecal incontinence. Dis Colon Rectum 2010; 53: 432–7.
10.1007/DCR.0b013e3181c75274
PubMed Web of Science® Google Scholar
13 Rockwood TH, Church JM, Fleshman JW et al. Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 2000; 43: 9–16; discussion 16–7.
10.1007/BF02237236
CAS PubMed Web of Science® Google Scholar
14 Govaert B, Pares D, Delgado-Aros S, La Torre F, Van Gemert WG, Baeten CG. A prospective multicentre study to investigate percutaneous tibial nerve stimulation for the treatment of faecal incontinence. Colorectal Dis 2010; 12: 1236–41.
10.1111/j.1463-1318.2009.02020.x
CAS PubMed Web of Science® Google Scholar
15 de la Portilla F, Rada R, Vega J, Gonzalez CA, Cisneros N, Maldonado VH. Evaluation of the use of posterior tibial nerve stimulation for the treatment of fecal incontinence: preliminary results of a prospective study. Dis Colon Rectum 2009; 52: 1427–33.
10.1007/DCR.0b013e3181a7476a
PubMed Web of Science® Google Scholar
16 Findlay JM, Yeung JM, Robinson R, Greaves H, Maxwell-Armstrong C. Peripheral neuromodulation via posterior tibial nerve stimulation – a potential treatment for faecal incontinence? Ann R Coll Surg Engl 2010; 92: 385–90.
10.1308/003588410X12628812459652
PubMed Web of Science® Google Scholar
17 Mentes BB, Yuksel O, Aydin A, Tezcaner T, Leventoglu A, Aytac B. Posterior tibial nerve stimulation for faecal incontinence after partial spinal injury: preliminary report. Tech Coloproctol 2007; 11: 115–9.
10.1007/s10151-007-0340-3
CAS PubMed Google Scholar
18 Shafik A, Ahmed I, El-Sibai O, Mostafa RM. Percutaneous peripheral neuromodulation in the treatment of fecal incontinence. Eur Surg Res 2003; 35: 103–7.
10.1159/000069399
CAS PubMed Web of Science® Google Scholar
19 Findlay JM, Maxwell-Armstrong C. Posterior tibial nerve stimulation and faecal incontinence: a review. Int J Colorectal Dis 2011; 26: 265–73.
10.1007/s00384-010-1085-4
PubMed Web of Science® Google Scholar

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Volume14, Issue9

September 2012

Pages 1101-1105

Short-term outcome following percutaneous tibial nerve stimulation for faecal incontinence: a single-centre prospective study

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Short-term outcome following percutaneous tibial nerve stimulation for faecal incontinence: a single-centre prospective study

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