Randomized controlled trial of percutaneous <i>versus</i> transcutaneous posterior tibial nerve stimulation in faecal incontinence

George, Anil Thomas; Kalmár, Katalin; Sala, S.; Kopanakis, Konstantinos; Panarese, Alessandra; Dudding, T. C.; Hollingshead, James; Nicholls, R. J.; Vaizey, C. J.

doi:10.1002/bjs.9000

Cited by 93 publications

(94 citation statements)

References 31 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%

“…However, in many studies, the anorectal physiological test results, which were performed after the treatment, did not change despite clinical improvements. 5,22 Despite the significant clinical improvement in the PTNS group, in their randomized trial, George et al 26 reported that there was no significant difference between the PTNS and placebo group in terms of anorectal physiological tests. Moreover, some data have indicated that post-treatment results are not related to the pretreatment anal manometer tests and anal ultrasound results.…”

Section: Discussionmentioning

confidence: 98%

“…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%

“…In addition, 15 (68%) patients experienced more than 50% reduction in the number of FI episodes. Transcutaneous nerve stimulation (TNS) has shown equivalently successful results as PTNS; 28,29 but George et al 26 found no difference between TNS and the control group. We have no experience with transcutaneous TSS in our clinic.…”

Section: Discussionmentioning

confidence: 99%

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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: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…In selected patients with multiple sclerosis (i.e, with less severe, stable disease and low symptom load) there may be a role for this technique. Less invasive procedures like tibial nerve stimulator have been shown to be effective in managing bowel function in patients with idiopathic incontinence and are being assessed for their use in improving bowel function in multiple sclerosis patients [32,33].…”

Section: Interventionsmentioning

confidence: 99%

Multiple Sclerosis Related Bowel Dysfunction: Pathophysiology, Clinical Manifestation and Management

Thiruppathy¹,

Preziosi²

2014

J Neurol Neurophysiol

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Bowel dysfunction amongst multiple sclerosis (MS) patients often manifests as faecal incontinence (FI), constipation, or a combination of the two. Its pathophysiology is poorly understood and can be multifactorial. Anorectal physiology provides an objective assessment of lower bowel functions and is increasingly being used in clinical practice. Due to the varied and fluctuant nature of the symptoms, these patients can be a management challenge. This review aims to give an overview of the pathophysiology, clinical manifestations and the principles of management of multiple sclerosis patients with bowel dysfunction.

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Randomized clinical trial of percutaneous tibial nerve stimulation versus sham electrical stimulation in patients with faecal incontinence

Wilt

Giuliani

Kubis³

et al. 2017

British Journal of Surgery

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Randomized controlled trial of percutaneous versus transcutaneous posterior tibial nerve stimulation in faecal incontinence

Abstract: NCT00530933 (http://www.clinicaltrials.gov).

Cited by 93 publications

References 31 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

Multiple Sclerosis Related Bowel Dysfunction: Pathophysiology, Clinical Manifestation and Management

Randomized clinical trial of percutaneous tibial nerve stimulation versus sham electrical stimulation in patients with faecal incontinence

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