Early reports on posterior tibial nerve stimulation (PTNS) show this to be a safe and effective treatment for fecal incontinence (FI). However, it is not known which of the two routes of administration, percutaneous or transcutaneous, is more effective. We aimed to compare transcutaneous and percutaneous stimulation through a blinded randomised placebo-controlled prospective trial.
Patients who had failed conservative treatment for FI were blinded and randomised into one of three groups- Group1: Percutaneous, Group 2: Transcutaneous, Group 3: Sham transcutaneous. Following a baseline assessment of bowel symptoms for two weeks, patients in Group 1 and Group 2 received PTNS twice weekly for 6 weeks. Although Group 3 patients had transcutaneous stimulation electrodes physically in place, no stimulation was delivered during the entire 6 week study period. All patients were subsequently unblinded and were followed for a further 1 month.
Thirty patients (M:F-2:28) participated in the study. Nine of the 11 patients (82%) in Group 1, 5 of the 11 (45%) patients in Group 2 and 1 of the 8 patients (12.5%) in Group 3 had a > 50% reduction in weekly episodes of FI at the end of the 6-week trial phase (Table attached). The above patients also showed a simultaneous improvement in their ability to defer defecation, St Mark’s Scores and in the SF 36 and Rockwood fecal incontinence quality of life scores. All the improvements in continence observed were sustained at the post study 1-month follow up. No complications occurred during the study period.
Source: Original Poster