Percutaneous electrical stimulation of the posterior tibial nerve for the treatment of fecal incontinence: manometric results after 6 months of treatment

Manso, Belen; Alías, David; Franco, Rocío Tovar; Levano-Linares, César; Laiz, Beatriz; García-Olmo, Damián; Durán, Manuel; Ruíz-Tóvar, Jaime

doi:10.1007/s00384-020-03564-4

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…In 2015, Knowles et al randomized 227 patients to receive PTNS or sham stimulation failing to demonstrate any effective benefit of PTNS to treat FI in adults [15]. The most recent results on PTNS use are more encouraging, as in most studies the manometric results intended as resting pressure and squeeze pressure and the Wexner score after treatment were improved [16,17]. In a trial by Solon et al, 81 patients with FI performed PTNS with an 80% success rate.…”

Section: Literature Resultsmentioning

confidence: 99%

Sacral and Percutaneous Tibial Nerve Stimulation, Stem Cell Therapy, and Transanal Irrigation Device

et al. 2022

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The early experiences with sacral nerve stimulation for refractory overactive bladder (OAB) [1] by urologists stimulated colorectal surgeons to use this procedure also for bowel dysfunctions, such as fecal incontinence (FI) [2] and chronic constipation (CC) [3,4]. The first experience for FI was described by Matzel [2], and then the International Consultation on Incontinence in 2013 introduced sacral nerve stimulation (SNS) as a first-line treatment for FI in patients without or with minimal sphincter defect and as a second choice in those with moderate or large defects [5]. How It WorksThe sacral nerves S2-S4 modulate pelvic sensitivity and the motility of the urologic and gastrointestinal functions of the pelvic floor. Electrical stimulation of the sacral roots creates a modulation of motor, sensory and autonomous nerve pathways in both the peripheral and central system, accounting for good outcomes in such different conditions as FI, CC, OAB, urinary incontinence, and low anterior resection syndrome (LARS) [6].

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Section: Literature Resultsmentioning

confidence: 99%

Sacral and Percutaneous Tibial Nerve Stimulation, Stem Cell Therapy, and Transanal Irrigation Device

et al. 2022

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“…Whilst the exact mechanism of action remains elusive, several authors have attempted to measure the physiological effects of tibial nerve stimulation using anorectal manometry. Various results have been presented, including no changes in resting or squeeze pressure [ 13 , 25 – 27 ], an improvement in MSP alone [ 28 ] or an improvement in both MRP and MSP [ 29 , 30 ]. In one randomised study, the authors noted the same changes in sphincter pressures in both the active and sham treatment arms [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Short-term clinical and manometric outcomes of percutaneous tibial nerve stimulation for faecal incontinence: a large single-centre series

O’Connor,

Molyneux,

Foster

et al. 2024

Tech Coloproctol

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Background Faecal incontinence (FI) is common, with a significant impact on quality of life. Percutaneous tibial nerve stimulation (PTNS) is a therapy for FI; however, its role has recently been questioned. Here we report the short-term clinical and manometric outcomes in a large tertiary centre. Methods A retrospective review of a prospective PTNS database was performed, extracting patient-reported FI outcome measures including bowel diary, the St Marks’s Incontinence Score (SMIS) and Manchester Health Questionnaire (MHQ). Successful treatment was > 50% improvement in symptoms, whilst a partial response was 25–50% improvement. High-resolution anorectal manometry (HRAM) results before and after PTNS were recorded. Results Data were available from 135 patients [119 (88%) females; median age: 60 years (range: 27–82years)]. Overall, patients reported a reduction in urge FI (2.5–1) and passive FI episodes (2–1.5; p < 0.05) alongside a reduction in SMIS (16.5–14) and MHQ (517.5–460.0; p < 0.001). Some 76 (56%) patients reported success, whilst a further 20 (15%) reported a partial response. There were statistically significant reductions in rectal balloon thresholds and an increase in incremental squeeze pressure; however, these changes were independent of treatment success. Conclusion Patients report PTNS improves FI symptoms in the short term. Despite this improvement, changes in HRAM parameters were independent of this success. HRAM may be unable to measure the clinical effect of PTNS, or there remains the possibility of a placebo effect. Further work is required to define the role of PTNS in the treatment of FI.

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The Role of Percutaneous Tibial Nerve Stimulation (PTNS) in Low Anterior Resection Syndrome (LARS): A Systematic Review and Meta-analysis

Liapis

Baloyiannis²,

Perivoliotis³

et al. 2023

J Gastrointest Canc

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Percutaneous electrical stimulation of the posterior tibial nerve for the treatment of fecal incontinence: manometric results after 6 months of treatment

Cited by 4 publications

References 19 publications

Sacral and Percutaneous Tibial Nerve Stimulation, Stem Cell Therapy, and Transanal Irrigation Device

Sacral and Percutaneous Tibial Nerve Stimulation, Stem Cell Therapy, and Transanal Irrigation Device

Short-term clinical and manometric outcomes of percutaneous tibial nerve stimulation for faecal incontinence: a large single-centre series

The Role of Percutaneous Tibial Nerve Stimulation (PTNS) in Low Anterior Resection Syndrome (LARS): A Systematic Review and Meta-analysis

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