Percutaneous tibial nerve stimulation (pTNS): success rate and the role of rectal capacity

Marti, Lukas; Galata, Christian; Beutner, Ulrich; Hetzer, Franc; Pipitone, Nicoletta; Wolff, Katja; Borovicka, Jan; Brunner, W; Sulz, Michael Christian; Maurus, Christine

doi:10.1007/s00384-017-2804-x

Cited by 15 publications

(5 citation statements)

References 29 publications

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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%

“…In one randomised study, the authors noted the same changes in sphincter pressures in both the active and sham treatment arms [ 22 ]. In two randomised studies, rectal sensory volumes were unchanged following tibial nerve stimulation [ 22 , 26 ] whilst demonstrating a non-significant reduction in another series [ 27 ]. When considering baseline measurements, none of these parameters have demonstrated an ability to predict the success of PTNS treatment [ 31 ], a finding that is supported by the results in our series.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…There was a significant improvement in micturition frequency, nocturia, and urge incontinence episodes in the PTNS group, with the impact obvious by week 10 of therapy. With a wide range of PTNS times, 61.5 percent of subjects self-proclaimed > 50% improvement in signs and symptoms, raising the subjective accomplishment percentages[ 117 ]. For a 12-wk treatment period, a recent randomized research of forty women with nocturia of weekly TTNS periods compared pelvic floor muscle training and behavioral therapy.…”

Section: Other Methods Of Neuromodulationmentioning

confidence: 99%

Electrical neuromodulation therapy for inflammatory bowel disease

Yasmin¹,

Sahito²,

Mir³

et al. 2022

World J Gastrointest Pathophysiol

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Inflammatory bowel disease (IBD) is an inflammatory disease of the gastrointestinal (GI) tract. It has financial and quality of life impact on patients. Although there has been a significant advancement in treatments, a considerable number of patients do not respond to it or have severe side effects. Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options. Although bioelectric neuromodulation technology has evolved significantly in the last decade, sacral nerve stimulation (SNS) for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease. For IBD treatment, several electrical neuromodulation techniques have been studied, such as vagus NS, SNS, and tibial NS. Several animal and clinical experiments were conducted to study the effectiveness, with encouraging results. The precise underlying mechanisms of action for electrical neuromodulation are unclear, but this modality appears to be promising. Randomized control trials are required to investigate the efficacy of intrinsic processes. In this review, we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.

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“…The delivery of LFES with skin electrodes placed on the sites corresponding to the gastrointestinal segment with abnormal motility patterns ( 48 ) can trigger the contractions of gastrointestinal smooth muscle cells and can thus stimulate peristalsis, gastric emptying, intestinal transit and absorption ( 49 ). Furthermore, the activation of submucosal and myenteric plexuses by LFES facilitates gastrointestinal fluid secretion, and blood and lymphatic circulation in the gastrointestinal tract post- ( 50 ). Overall, LFES promotes the early recovery of gastrointestinal function, post-operative exhaust and defecation, and also alleviates abdominal distension and pain by stimulating gastrointestinal peristalsis ( 51 ).…”

Section: Low-frequency Electrical Stimulationmentioning

confidence: 99%

Low-frequency electrical stimulation promotes the recovery of gastrointestinal motility following gynecological laparoscopy (Review)

Tian

Gao

et al. 2022

Med Int

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The rapid recovery of gastrointestinal transit is critical for clinical recovery following laparoscopic procedures, including gynecological laparoscopies (GLs). Rehabilitation interventions post-surgery may provide significant prevention against early post-operative gastrointestinal motility disorders and maid aid in the acceleration of post-operative recovery in patients undergoing GLs. Among others, low-frequency electrical stimulation (LFES) has been demonstrated to pronouncedly mitigate the symptoms caused by gastrointestinal motility disorders; thus, this has attracted increasing attention over the past decade. The present study aimed to present an overview of the efficacy and application of LFES in gastrointestinal motility recovery following GL procedures.

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Percutaneous tibial nerve stimulation (pTNS): success rate and the role of rectal capacity

Abstract: These results demonstrate that pTNS can improve the symptoms and quality of life of patients with fecal urge incontinence. However, the study fails to demonstrate a correlation between treatment success and changes in rectal capacity.

Cited by 15 publications

References 29 publications

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

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

Electrical neuromodulation therapy for inflammatory bowel disease

Low-frequency electrical stimulation promotes the recovery of gastrointestinal motility following gynecological laparoscopy (Review)

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