Evaluation of the Use of Posterior Tibial Nerve Stimulation for the Treatment of Fecal Incontinence: Preliminary Results of a Prospective Study

Portilla, Fernando de la; Rada, Ricardo; Vega, Juan Diego Sánchez; González, C. Almeida; Cisneros, N.; Maldonado, Víctor

doi:10.1007/dcr.0b013e3181a7476a

Cited by 73 publications

(63 citation statements)

References 16 publications

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“…Furthermore, improvements in patient quality of life have been observed. 22,24,25,26,27 Consistently, PTNS also improved the FI score and quality-of-life values in our study. In addition, 15 (68%) patients experienced more than 50% reduction in the number of FI episodes.…”

Section: Discussionsupporting

confidence: 87%

“…The session duration is usually 30 minutes, and the session frequency varies between once or twice per week and every other day, with the total treatment duration ranging from 6 weeks to 3 months. 22,24,25,26 We used a protocol of 30-minute sessions per week and a total of 10 sessions because a substantial portion of patients lived far from the clinic. Previous studies of PTNS have revealed that the procedure reduces the frequency of FI episodes by more than 50%.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of percutaneous tibial nerve stimulation and bulking agent injection (polyacrylonitrile) in treating fecal incontinence

Keskin¹,

Karıp²,

Şahbaz³

et al. 2016

TJCD

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Amaç: Fekal inkontinans, halen kolorektal cerrahların günlük pratiği içinde kompleks bir sorun olmayı sürdürmektedir. Sinir stimülasyonu ve dolgu madde enjeksiyonu bu hastalığın tedavisi için kullanılan iki minimal invaziv tedavi yöntemidir. Bu çalışmamızda, fekal inkontinans tedavisinde, perkütan tibial sinir stimülasyonu (PTSS) ile dolgu madde enjeksiyonu yöntemlerinin kısa dönem sonuçlarını değerlendirmeyi amaçladık. Yöntem: İstanbul Üniversitesi İstanbul Tıp Fakültesi'nde fekal inkontinans nedeniyle bu iki yöntemin uygulandığı 41 hasta çalışmaya dahil edildi. İki grup demografik veriler, fekal inkontinans etiyolojisi, anorektal fizyolojik testler, Wexner Fekal İnkontinans Skoru ve Modifiye Fekal İnkontinans Yaşam Kalite Skoru açısından değerlendirildi. Anketler tedavi öncesi ve tedavi sonrası 12. ayda yapıldı. Bulgular: Hastaların 24'ü (%59) kadın, 17'si (%41) erkekti. Ortalama yaş 50 (25-71) ve ortalama vücut kitle indeksi ise 27,7 kg/m 2 (20-41) idi. Yirmi iki (%54) hastaya PTSS uygulanırken, 19 hastaya (%46) dolgu madde enjeksiyonu yapıldı. Her iki grup demografik veriler, tedavi öncesi yapılan fekal inkontinans değerlendirme ve yaşam kalite ölçümü açısından benzeşik bulundu. Tedavi öncesi ve sonrası, inkontinans ve yaşam kalite ölçek skorları karşılaştırıldığında, her iki yöntem de fekal inkontinans tedavisinde etkin bulundu (p<0,001). Her iki yöntem kendi arasında karşılaştırıldığında, eşdeğer oldukları görüldü (p=0,315 ve 0,501). Sonuç: Her iki teknik, fekal inkontinansın tedavisinde etkin bulunmuştur. PTSS daha az invazivken, dolgu madde enjeksiyonu ile daha hızlı düzelme elde edilmekte ve hasta geliş sayısı daha az olmaktadır. Anahtar Kelimeler: Fekal inkontinans, sinir stimülasyonu, dolgu madde enjeksiyonu ÖZ ABSTRACTAim: Fecal incontinence is still a complex disorder in the daily practices of colorectal surgeons. Nerve stimulation and injection of bulking agent are two minimal invasive methods in the treatment of fetal incontinence. In the present study, the aim was to compare the short-term effectiveness of percutaneous tibial nerve stimulation (PTNS) and injection of bulking agent in the treatment of fecal incontinence. Method: A total of 41 patients with fecal incontinence, who were treated with PTNS or bulking agent injection at İstanbul University İstanbul Faculty of Medicine, were enrolled in the study. Both groups were evaluated in terms of demographic data, the etiology of fecal incontinence, anorectal physiology test results, Wexner Fecal Incontinence Score and Modified Fecal Incontinence Quality of Life-Scale scores. The questionnaires were performed in the 12 th month of the pre-and post-treatment periods. Results: Of the patients, 24 (59%) were female, and 17 (41%) were male. The median age was 50 years (in between 25-71 years), and the mean body mass index was 27.7 kg/m 2 (in between 20-41 kg/m 2 ). Twenty-two (54%) patients underwent PTNS; whereas, 19 (46%) patients underwent bulking agent injection. Both groups were found to be similar in terms of demographic data, pre-treatment feca...

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Comparison of percutaneous tibial nerve stimulation and bulking agent injection (polyacrylonitrile) in treating fecal incontinence

Keskin¹,

Karıp²,

Şahbaz³

et al. 2016

TJCD

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“…Direct comparison with other studies is difficult because of aetiologic heterogeneity, the different protocols of PTNS administration and the various methods used to quantify any improvements. Nevertheless, our results provide further evidence that PTNS may be a simple, safe and effective treatment for FI [4][5][6].…”

Section: Discussionmentioning

confidence: 55%

“…Increasing evidence suggests that percutaneous tibial nerve stimulation (PTNS) is an effective treatment for FI with demonstrable improvement in clinical outcomes and quality of life scores [2,[4][5][6][7]. The published literature, however, is limited to a few methodologically heterogeneous studies with small numbers of participants.…”

Section: Introductionmentioning

confidence: 97%

Percutaneous tibial nerve stimulation (PTNS) in females with faecal incontinence: the impact of sphincter morphology and rectal sensation on the clinical outcome

Hotouras

Thaha

Allison

et al. 2012

Int J Colorectal Dis

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“…Otra modalidad de neuromodulación es la periférica, que consiste en la electroestimulación del nervio tibial posterior con electrodos percutáneos, lo que ha mostrado efectividad en la mejoría de la incontinencia, faltando estudios con mayor cantidad de pacientes que confi rmen esos resultados 40 .…”

Section: Neuromodulación Sacraunclassified

Incontinencia fecal del adulto

A¹,

M²,

G³

et al. 2011

Rev Chil Cir

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Fecal incontinence in adultsThe aim of this paper is to review the knowledge of this pathology by highlighting the clinical evolution, study and treatment. These different aspects need a multidisciplinary approach, because of their complex physiopathology, possible association with urinary incontinence and prolapse of the three compartments of the pelvis. The fecal incontinence (FI) constitutes a highly prevalent pathology that affects at least 2% of the population and up to 45% of the patients in nursing homes. This pathology can cause serious problems in physical, psychological, social, and economical levels. The clinical evaluation may identify or suspect the cause, and guide the study of FI. The initial treatment of the FI should always be medical one, often associated to biofeedback and the surgical treatment should be only reserved for refractory FI. Sphincteroplasty is indicated by defi ned defaults of the external sphincter, with good initial results (at least 70%) that fall to 50% in 5 years. The artifi cial neosphincter and the dynamic graciloplasty represent an option for patient without suffi cient sphincter mass for a plasty. In the last few years new techniques have appear with promising results, as the neuromodulation that uses electrodes in the sacral plexus or applied to the posterior tibial nerve. In conclusion the IF is a problem of large prevalence but kept in shadows because the patients tend to have reticence to declare it, and the doctors to inquire about. The focus should be multidisciplinary and the initial treatment must be medical one. The surgical treatment should be reserved for refractory FI.Key words: Fecal incontinence, endosonography, anal manometry, biofeedback, sphincteroplasty. ResumenEl propósito de esta revisión es actualizar los conocimientos sobre esta patología, destacando su evolución clínica, estudio y tratamiento, aspectos que ameritan un enfoque multidisciplinario, ya que, además de su compleja fi siopatología, puede asociarse a incontinencia urinaria y prolapso de los tres compartimentos de la pelvis. La incontinencia fecal (IF) constituye una patología altamente prevalente que afecta al menos un 2% de la población y hasta el 45% de los pacientes en casas de reposo; cuyas consecuencias pueden ocasionar al paciente serios problemas físicos, psicológicos, sociales y económicos. La evaluación clínica puede identifi car o sospechar la causa de la IF, y guiar el estudio de la misma. El tratamiento inicial de la IF debe ser siempre médico, a menudo asociado a biofeedback, y el tratamiento quirúrgico reservarse para la IF refractaria a estas

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Evaluation of the Use of Posterior Tibial Nerve Stimulation for the Treatment of Fecal Incontinence: Preliminary Results of a Prospective Study

Abstract: Percutaneous tibial nerve stimulation is a minimally invasive and effective treatment option for patients with fecal incontinence.

Cited by 73 publications

References 16 publications

Comparison of percutaneous tibial nerve stimulation and bulking agent injection (polyacrylonitrile) in treating fecal incontinence

Comparison of percutaneous tibial nerve stimulation and bulking agent injection (polyacrylonitrile) in treating fecal incontinence

Percutaneous tibial nerve stimulation (PTNS) in females with faecal incontinence: the impact of sphincter morphology and rectal sensation on the clinical outcome

Incontinencia fecal del adulto

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