Posterior tibial nerve stimulation for faecal incontinence after partial spinal injury: preliminary report

Menteş, B. Bülent; Yüksel, Osman; Aydin, Altan; Tezcaner, Tugan; Leventoğlu, Alev; Aytaç, Bülent

doi:10.1007/s10151-007-0340-3

Cited by 54 publications

(39 citation statements)

References 24 publications

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“…39 Although preliminary results for posterior tibial nerve stimulation seem promising, it is important to note that the statistical significance of the improvements in clinical and physiological parameters were not reported and the study involved only two subjects. 39 Level 4 evidence also exists for the use of functional magnetic stimulation on the thorax and lumbosacral nerves (simulation placed at T9 and L3 spinal processes) to reduce colonic transit times and selfreported symptoms of constipation. 40 Pharmacological agents Ten studies (aggregate N ¼ 199) evaluated the effect of treatment strategies using pharmacology to enhance bowel management ( Table 9).…”

Section: Resultsmentioning

confidence: 97%

“…Six studies (aggregate N ¼ 74) evaluated electrical or magnetic stimulation on skeletal muscles as a modality to improve colonic transit time in SCI with one study being an RCT (Table 8). [35][36][37][38][39][40] There is Level 1 evidence (from one good-quality RCT, however, with few subjects) that external electrical stimulation of the abdominal wall muscles can improve bowel management for individuals with tetraplegia. 35 They used an overnight abdominal belt with embedded electrodes to provide the stimulus.…”

Section: Resultsmentioning

confidence: 99%

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Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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Study design: Randomized-controlled trials (RCTs), prospective cohort, case-control, pre-post studies, and case reports that assessed pharmacological and non-pharmacological intervention for the management of the neurogenic bowel after spinal cord injury (SCI) were included. Objective: To systematically review the evidence for the management of neurogenic bowel in individuals with SCI. Setting: Literature searches were conducted for relevant articles, as well as practice guidelines, using numerous electronic databases. Manual searches of retrieved articles from 1950 to July 2009 were also conducted to identify literature. Methods: Two independent reviewers evaluated each study's quality, using Physiotherapy Evidence Database scale for RCTs and Downs and Black scale for all other studies. The results were tabulated and levels of evidence assigned. Results: A total of 2956 studies were found as a result of the literature search. On review of the titles and abstracts, 57 studies met the inclusion criteria. Multifaceted programs are the first approach to neurogenic bowel and are supported by lower levels of evidence. Of the non-pharmacological (conservative and non-surgical) interventions, transanal irrigation is a promising treatment to reduce constipation and fecal incontinence. When conservative management is not effective, pharmacological interventions (for example prokinetic agents) are supported by strong evidence for the treatment of chronic constipation. When conservative and pharmacological treatments are not effective, surgical interventions may be considered and are supported by lower levels of evidence in reducing complications. Conclusions: Often, more than one procedure is necessary to develop an effective bowel routine. Evidence is low for non-pharmacological approaches and high for pharmacological interventions.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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“…In most series with high success rates, follow-up is not adequate. There are two studies reporting a success rate of 100%, but with only 1 month of follow-up [21][22]. Follow-up is usually < 10 months in most publications.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Tibial Nerve Stimulation for Treatment of Idiopathic Faecal Incontinence: Mid-term Results from a Single Center

Inviati

Giovanni²,

Gullo

et al. 2016

J Gastrointest Dig Syst

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Objective: Percutaneous tibial nerve stimulation is a recent and minimally invasive treatment for faecal incontinence (FI). The aim of this study is to evaluate the mid-term results in patients with idiopathic faecal incontinence (IFI). Methods:Fifty one patients (42 female and 9 male) were prospectively recruited. Patients were treated twice a week for 6 weeks as per study protocol. We have assessed the degree of fecal incontinence using the Cleveland Clinic faecal incontinence (CCF-FI) score at baseline, at 6 weeks, at 6 months and at 1 year. Also the anorectal manometric data (mean resting pressure (MRP), squeeze pressure (SP) and, rectal sensation) at baseline, at 6 weeks and at 6 months have been evaluated. Results:The median CCF-FI score was significantly decreased from an initial baseline value from 12 to 7 at 6 weeks, 3 at 6 months and, 3 at 1 year (respectively: 1st interquartile 4.5, 1, 0 vs 10; 3rd interquartile 9, 5, 5 vs 14.5, p = 0.0001). Anorectal manometry showed an improvement of the internal (resting pressure, MRP) and the external sphincters (squeeze pressure, SP) at 6 months compared to the baseline and 6 weeks by PTNS, while, RP and SP at 6 months was greater than at baseline and 6 weeks (p = 0.004 and p = 0.002 respectively). Conclusions:This study demonstrates that stimulation of the posterior tibial nerve could be an excellent procedure for the treatment of IFI. The stimulation of the posterior tibial nerve can improve the fecal continence (CCF-FI score) in the short term and this improvement is maintained after 1 year of follow-up without treatment.

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“…78 The absolute contraindications include anal stenosis, recent rectal surgery, active inflammatory bowel disease, active diverticulitis, colorectal cancer and ischaemic colitis. 95,96 The main complication associated with TAI is bowel perforation. However, the rates for this are pretty low, with an estimated risk of irrigation-induced perforation to be one per 50,000 (0.0002%).…”

Section: Transanal Irrigationmentioning

confidence: 99%

“…95 An RCT by Leroi et al included neurogenic patients, while comparing TTNS with sham stimulation. Although no specific data or analysis were presented specifically for neurogenic patients, it did not report a significant improvement in the number of FI episodes or anorectal physiology.…”

Section: Tibial Nerve Stimulationmentioning

confidence: 99%

Evaluation and Treatment of Neurogenic Bowel Dysfunction – A Review

Kumar¹,

Athanasakos²,

Emmanuel³

2016

European Neurological Review

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Neurogenic bowel dysfunction is a severely troubling entity for patients with neurological disease or injury. The complex symptom cluster presents a challenge, not only for the patients but also for the treating clinician. Without intervention, patients are bound to have a reduced quality of life, and experience social impacts and secondary complications that come along with it. A careful initial assessment provides an idea of symptom severity and is crucial for successful rehabilitation. The mainstay of treatment remains a conservative approach of managing faecal incontinence or optimising the mechanics of defecation to improve patient’s quality of life. This article attempts to provide a comprehensive review of existing literature on pathophysiology, assessment and management of neurogenic bowel dysfunction.

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Posterior tibial nerve stimulation for faecal incontinence after partial spinal injury: preliminary report

Abstract: Posterior tibial nerve stimulation can be an effective method for the treatment of faecal incontinence caused by partial spinal cord injury.

Cited by 54 publications

References 24 publications

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

Percutaneous Tibial Nerve Stimulation for Treatment of Idiopathic Faecal Incontinence: Mid-term Results from a Single Center

Evaluation and Treatment of Neurogenic Bowel Dysfunction – A Review

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