Systematic review of tibial nerve stimulation to treat faecal incontinence

Horrocks, Emma J; Thin, Noel N.; Thaha, Mohamed A.; Taylor, Stephanie J C; Norton, Christine; Knowles, Charles H.

doi:10.1002/bjs.9391

Cited by 76 publications

(48 citation statements)

References 46 publications

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“…Percutaneous TNS was found to be effective in 37-100% of patients with idiopathic overactive bladder, in 41-100% of those with nonobstructive E U R O P E A N U R O L O G Y X X X ( 2 0 1 5 ) X X X -X X X urinary retention, and in upon 100% of patients with chronic pelvic pain syndrome, children with overactive bladder or dysfunctional voiding, and in patients with NLUTD [7]. In addition, TNS might improve fecal incontinence [33], highlighting the potential in the neurological patient often with both lower urinary tract and bowel dysfunction, although there is no high level of evidence study assessing the combined dysfunction. The exact mechanisms of action of neuromodulation procedures remain to be elucidated, but modulation of spinal cord reflexes and brain networks by peripheral afferents seems to be involved [34].…”

Section: Findings In the Context Of Existing Evidencementioning

confidence: 96%

Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

et al. 2015

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Section: Findings In the Context Of Existing Evidencementioning

confidence: 96%

Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

et al. 2015

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“…PTNS has been shown to be effective for fecal incontinence (FI) and shows promise for treating chronic pelvic pain. A recent systematic review showed that 63-82 % of patients reported greater than 50 % reduction in the number of FI episodes and that PTNS improved the quality of life of patients with FI [19]. A randomized study examining the effectiveness of PTNS in treating patients with chronic non-bacterial prostatitis (CP)/ chronic pelvic pain syndrome (CPPS) showed improvement in the mean NIH Chronic Prostatitis Symptom Index and Visual Analogue Score (p<0.001) [20].…”

Section: Ptns For Fecal Incontinence and Pelvic Painmentioning

confidence: 97%

Percutaneous Tibial Nerve Stimulation and Sacral Neuromodulation: an Update

et al. 2015

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Neuromodulation is an important treatment modality for a variety of pelvic floor disorders. Percutaneous tibial nerve stimulation (PTNS) and sacral neuromodulation (SNM) are currently the two approved methods for delivering this therapy. Percutaneous tibial nerve stimulation is a minimally invasive office-based procedure that has shown efficacy in the treatment of overactive bladder, fecal incontinence, and pelvic pain. It has the advantage of minimal side effects but is limited by the need for patients to make weekly office visits to receive the series of treatments. Sacral neuromodulation uses an implanted device that stimulates the S3 nerve root and can improve symptoms of overactive bladder, non-obstructive urinary retention, fecal incontinence, and pelvic pain. This paper will review the most recent literature regarding this topic and discuss their advantages and limitations and recent innovations in their use.

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“…Nevertheless, most published TTNS and PTNS studies with FI patients are small, uncontrolled and with heterogeneous patient populations (9,14). Only 15-45% of those suffering from FI consult medical services, owing to embarrassment and lack of knowledge about potential treatments (32,33).…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous tibial nerve stimulation for the treatment of faecal incontinence: results of a prospective study

Stundiene¹,

Žeromskas²,

Valantinas³

2014

AML

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Background. Transcutaneous tibial nerve stimulation is a simple, non-invasive treatment, which can be used to treat faecal incontinence. Optimal treatment regimen is not known and various stimulation regimens are used in different centers. The aim of this prospective study was to evaluate the efficacy of twice weekly transcutaneous tibial nerve stimulation for faecal incontinence patients, who have failed to respond to maximal conservative treatment. Material and methods. Twenty patients with faecal incontinence resistant to maximal conservative therapy were treated with transcutaneous posterior tibial nerve stimulation twice a week for six weeks. The number of the bowel movements per two weeks and the Cleveland Clinic Florida Feacal Incontinence Score were assessed before and after the treatment. The quality of life was estimated using the Faecal Incontinence Quality of Life questionnaire and the Gastrointestinal Quality of Life Index. Results. Effect was seen in 55% of patients. Two-week faecal incontinence episodes decreased from median 4 (2–84) to 2 (0–56) (p = 0.002). The mean Cleveland Clinic Florida Faecal Incontinence score improved from 10.9 ± 4.34 to 7.8 ± 3.96 (p = 0.002). The quality of life improved significantly after the treatment. The therapy was well tolerated and no participant experienced any adverse event. Conclusions. Transcutaneous tibial nerve stimulation twice a week for 6 weeks may be efficacious in patients with faecal incontinence, who have failed to respond to maximal conservative treatments.

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Systematic review of tibial nerve stimulation to treat faecal incontinence

Abstract: PTNS and TTNS result in significant improvements in some outcome measures; however, TTNS was not superior to sham stimulation in a large, adequately powered, RCT. As no adequate RCT of PTNS versus sham has been conducted, conclusions cannot be drawn regarding this treatment.

Cited by 76 publications

References 46 publications

Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

Percutaneous Tibial Nerve Stimulation and Sacral Neuromodulation: an Update

Transcutaneous tibial nerve stimulation for the treatment of faecal incontinence: results of a prospective study

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