Percutaneous tibial nerve stimulation vs sacral nerve stimulation for faecal incontinence: a comparative case‐matched study

Abstract

Posterior tibial nerve stimulation is a valid method of treating faecal incontinence in the short term when conservative treatment has failed. It is easier, simpler, cheaper and less invasive than SNS with a similar short-term outcome.

International Continence Society best practice statement for use of sacral neuromodulation

“…Comparative studies are scarce. One study compared 23 patients randomized to SNM versus 17 randomized to percutaneous tibial nerve stimulation . Though short‐term outcomes were acceptable in both groups, the design of the study did not allow statistical comparison between groups.…”

“…One study compared 23 patients randomized to SNM versus 17 randomized to percutaneous tibial nerve stimulation. 49,50 Though short-term outcomes were acceptable in both groups, the design of the study did not allow statistical comparison between groups. One study compared 15 patients treated with SNM to 15 historical controls treated with the artificial bowel sphincter.…”

“…There is a large and growing body of evidence that a defect of the internal or external sphincter is not a contraindication for SNM for FI . Though clinical success has been reported in patients with sphincter defects up to 180 degrees, most would agree that the size of the defect does not matter and should not affect decision making . This is likely because the proposed mechanism of action relies more on sensory nerve fibers and bowel motility than on muscular contraction .…”

Clinical Challenges of Fecal Incontinence in the Elderly

“…In a study comparing SNS to PTNS in patients with FI, the authors did not find any significant difference in efficacy at 6 and 12 months between the two treatment groups [96]. PTNS is less expensive and less invasive than SNS and therefore associated with less adverse events.…”

Evidence-Based Update on Treatments of Fecal Incontinence in Women

“…Al Asari et al reported no significant differences in the mean Wexner and FI Quality of Life (FIQoL) scores between PTNS and SNS groups up to 12 months on treatment of refractory FI. [98] A RCT comparing PTNS and SNS in the treatment for FI is currently being undertaken in Switzerland (NCT01069016). [100,104]…”