A prospective single blinded placebo controlled study into the role of percutaneous and transcutaneous tibial nerve stimulation for faecal incontinence: Table 1

Abstract

Purpose: Early reports(1,2) on posterior tibial nerve stimulation (PTNS) show this to be a safe and effective treatment for faecal 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. Methods: 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. Results: 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 faecal 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. Conclusions: This study demonstrates the efficacy of PTNS with evidence suggesting that percutaneous stimulation is more effective than transcutaneous. (Table Presented).