Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review

Abstract

Fecal incontinence is a condition that carries high social stigmatization and a determining factor in the quality of life of the person who suffers from it. Its etiology is multifactorial and treatment includes surgical and conservative measures, including stimulation of the posterior tibial nerve. The aim of this review is to determine whether posterior tibial nerve stimulation (PTNS) is more effective than other treatments in reducing episodes of fecal incontinence in adults. A systematic review of randomized clinical trials that analyzed different approaches and comparisons with other treatments in adults without neurological or metabolic diseases was carried out, analyzing, fundamentally, the reduction of episodes of fecal incontinence. In general, a reduction in fecal incontinence episodes is observed in the experimental groups compared with the control groups, although these differences are not significant in most studies. The results regarding the effectiveness of PTNS in reducing episodes of fecal incontinence compared to other treatments are not entirely conclusive, although benefits are observed regarding the stimulation of sacral roots. More well-designed studies with a long-term follow-up of the results are needed so that the recommendation of this treatment can be generalized.

Long-Term Outcome of Transcutaneous Posterior Tibial Nerve Stimulation in the Treatment of Functional Non-Retentive Fecal Incontinence in Children

“…20 One main point in the outcome in treatment of FNRFI is the decrease in the FI severity throughout decrease the FI episodes and improvement of FI score. For the effectiveness of TPTNS, several studies 21-25 reported statistically significant improvement of FI score after 3 months or after 6 months as reported by Eleouet et al . 23 Others continued the follow-up for 12 months and reported the same results.…”

“…20 One main point in the outcome in treatment of FNRFI is the decrease in the FI severity throughout decrease the FI episodes and improvement of FI score. For the effectiveness of TPTNS, several studies [21][22][23][24][25] reported statistically significant improvement of FI score after 3 months or after 6 months as reported by Eleouet et al 23 Others continued the follow-up for 12 months and reported the same results. All of the above-reported results matched the results of the present study where there was a statistically significant improvement of the FI score at 6, 12, 24 months when compared to the baseline.…”

“…3 FI has a major negative impact on the quality of life (QoL) and occasionally results in depression and social exclusion. 4,5 Intact muscles of the pelvic floor, the anal sphincter, local sensory and motor nerves, as well as cortical and spinal connections all contribute to the maintenance of Fecal continence. 6 Fecal incontinence can result from dysfunction of any of these structures so it is a more complicated and multifaceted illness.…”

“…3 FI has a major negative impact on the quality of life (QoL) and occasionally results in depression and social exclusion. 4,5…”

The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial

“…PNS can be applied at many anatomical sites, either transcutaneously, percutaneously, or by spinal cord stimulation from electrodes implanted in the spine [11]. Transcutaneous posterior tibial nerve stimulation (PTNS) is especially used in diseases such as overactive bladder, fecal incontinence, chronic pelvic pain, and chronic prostatitis [12][13][14]. It is easy to apply, practical, and has no significant side effects.…”