Percutaneous tibial nerve stimulation cuts number of weekly faecal incontinence episodes
Percutaneous tibial nerve stimulation (PTNS) may be moderately effective for patients with faecal incontinence (FI) who respond poorly to conventional treatments, new randomized controlled trial (RCT) has shown.
The single-blinded RCT included 59 FI patients experiencing lifestyle disruptions. Only those who found previous conservative treatments ineffective and who were psychologically stable were included. Exclusion criteria included pregnancy, clinical history of multiple sclerosis or spina bifida and major sphincter defect.
Participants received either PTNS (n=29; median age 64.0 years) or sham stimulation (n=30; median age 65.5 years) for 9 weeks. The primary outcome was median number of FI episodes per week. Secondary outcomes were quality of life (QoL) and symptom severity.
Of the 29 patients in the PTNP group, 13 showed a reduction in median FI episodes of >50 percent. In comparison, only six of the 30 patients in the sham group showed a >50 percent reduction (incidence risk ratio [IRR], 2.40; 95 percent CI, 1.10 to 5.24; p=0.028).
The decline in the median number of FI episodes per week was 34 percent greater in the PTNS group (5.0 to 3.0 FI events) than in the sham group (stable at 7.0 FI events; IRR, 0.66; 0.44 to 0.98; p=0.041).
Cleveland Clinic Florida faecal incontinence scale scores showed greater declines from baseline to after treatment in the PTNS group compared with the sham group (mean difference [MD], -1.3; -2.6 to 0.0; p=0.049).
Faecal incontinence QoL showed significant improvements after treatment in both groups. There were no significant differences in scores in any of the domains between the two treatment groups.