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A prospective multicentre study to investigate percutaneous tibial nerve stimulation (PTNS) for the treatment of faecal incontinence.

Govaert, B., et al. (2008). The Association of Coloproctology of Great Britain and Ireland Colorectal Disease, 10(Suppl 2), 2.

AIM: PTNS is minimally invasive treatment that can be performed in the outpatient clinic. A pilot study was carried out to investigate the efficacy of PTNS in the treatment of faecal incontinence (FI).
 
METHOD: PTNS was performed by the insertion of a needle-electrode near the posterior tibial nerve. The electrode was connected to a stimulator. Its position was confirmed by foot sole sensation and toe flexion. Patients were treated twice a week by a 30 minute stimulation period. The patients were evaluated at 6 weeks by diary recording and CCFI scores.
 
RESULTS: Seventeen patients were included. The mean age was 62.3 ± 11.4 (36-81). All patients responded with a toe reflex on PTNS test stimulation and underwent the 6-week treatment. After 6 weeks 14 continued the programme, three stopped because of lack of efficacy. CCFI scores improved significantly from 11.7 to 8.1 at 6 weeks (P < 0.001) and to 6.3 at 3 months (n = 6,  P= 0.007). The mean number of incontinence episodes decreased significantly from 12.9 to 6.5 (P = 0.04) at 6 weeks.
 
CONCLUSION: PTNS can be an effective treatment for FI. Patient selection and practical consequences have to be investigated.
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