Nicholson, J., Pearson, J.S., Molyneux, C., Sharma, A., Telfrod, K.J., and Kiff, E. PWE-388.
Posterior tibial nerve stimulation (PTNS) is a new neuromodulation treatment for faecal incontinence (FI).
Our aim of this study was to establish if PTNS is effective, and for which subgroups of FI and whether it influences
Prospective observational cohort study in a tertiary pelvic floor unit. Patients received PTNS for 30 mins once a
week for 12 weeks. High resolution anal manometry (HRAM), 2-week bowel diary, FI severity score (Vaizey), FI specific
QOL questionnaire (MHQ) were recorded before and 2-weeks after treatment. Clinical data and subjective patient
reported outcomes (success/fail) were recorded.
23 patients, 19 (83 %) women, median age 62 (31-78). 12 (52 %) mixed incontinence, 7 (30 %) urge
incontinence, 4 (18 %) passive incontinence. We found a reduction in the mean number of urgency episodes (19 v 11,
p=0.002), urge FI episodes (6 v 2, p=0.038) and passive FI episodes (12 v 8, p=0.154), with an improvement in Vaizey
(16.7 v 14.4, p=0.003) and MHQ (481.9 v 413.1 p=0.039) scores.
All HRAM variables (mmHg) increased; MRP (40 v 46, p=0.088), MSP (72 v 92, p=0.009) and ISP (32 v 45, p=0.031).
Increased rectal sensation (mls); onset (42 v 33, p=0.064), call (80 v 54, p=0.000) and urge (112 v 82, p=0.001).
Subjective success occurred in 74 % (17), 4 of 6 that failed had passive incontinence. Objective success (defined as >50
% or >70 % improvement in 2 or more of the following; overall FI episodes, urgency episodes, urge FI episodes, passive
FI episodes, Vaizey and MHQ scores) was seen in 52 % (12) and 39 % (9) respectively. 3 of the 4 men did not improve
subjectively or objectively.
PTNS subjectively helped 17 of 23 patients, reflected in improved questionnaires and fewer incontinence
episodes. They had increased rectal awareness and stronger squeeze pressures which may have given them more
warning and the ability to defer defecation. This study suggests that PTNS appears to help women with urge incontinence.
Click here to see the full PDF.