Percutaneous tibial nerve stimulation can improve symptoms and quality of life in selected patients with faecal incontinence - A single-centre 5-year clinical experience

摘要

Introduction: Faecal incontinence is a debilitating condition that affects a significant proportion of the population. Conservative management remains the mainstay of treatment but surgical intervention such as neuromodulation can be indicated in cases refractory to medical therapy. Aim: The aim of this study was to review the outcomes of patients who underwent percutaneous tibial nerve stimulation (PTNS) for faecal incontinence and urgency in a single institution over five years. Results: Eighty-one patients completed the 12-week trial of PTNS with a success rate of 80% (n = 64/81). Rates of faecal incontinence and urgency were reduced from 13 episodes per fortnight to 3 and from 10 to 3 respectively. Over a median follow up of 2 years (range 0-5 years) reduction in rates of faecal urgency and incontinence were maintained. Quality of life parameters were measured using a variety of established questionnaires. Improvements were observed in the majority of parameters that were maintained throughout the follow up period. Conclusion: Percutaneous tibial nerve stimulation is one of the forms of neuromodulation available for the treatment of faecal incontinence and urgency in patients who failed conservative management. This study has shown that in carefully selected, motivated patients, the use of PTNS in conjunction with regular counseling from a specialist practitioner in pelvic floor disorders can improve both the symptoms and quality of life of patients with faecal urgency and mild faecal incontinence with improvements in symptomology maintained for up to 5 years. (C) 2019 Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.