Evaluation of percutaneous posterior tibial nerve stimulation efficacy for patients with faecal incontinence

Abstract

Aim: percutaneous posterior tibial nerve stimulation (PTNS) is one of neuromodulating methods used for faecal incontinence treatment. This method has been used for four years in Lithuania. The aim of our study is to evaluate the efficiency of this method on continence and quality of live. Methods: patients with faecal incontinence and anatomically intact sphincter muscles and extant anorectal reflexes after anal manometry and endorectal ultrasound examination, prospectively were included in this study. Incontinence severity was evaluated by Wexner scale and specific quality of live (QOL) questionnaire SF 36 before and after treatment. Treatment lasts 20 PTNS sessions (1 month) by applying 200 μs, 10 mA, 10 Hz current to both n. tibialis posterior. Wilcoxon test for dependent samples was used to determine the statistically significant differences. Results: 21 patient were recruited to the study in 24 month period. Data of 16 (76 %) patients with good effect of treatment was analysed. The Wexner score improved after treatment from 13,9 ± 3,9 to 11,1 ± 5 (p = 0,091). The Lifestyle alteration question from the Wexner questioner value improved from 2,96 ± 1,9 to 2,14 ± 1,4 (p = 0,016), The improvement of general QOL after treatment was discovered either from 53,33 ± 20,4 to 58,1 ± 25,3 (p = 0,27), a lifestyle domain questions value from 14,04 ± 5,4 to 22,1 ± 7,3 (p = 0,048), a depression/ self-perception domain – from 11,2 ± 3,9 to 13,5 ± 4,8 (p = 0,2). Conclusion: PTNS is effective and acceptable method of faecal incontinence treatment with significant effects on patients lifestyle. The bigger numbers of participant are needed to get statistically reliable results of other parts of tests values.