Randomized controlled trial of percutaneous versus transcutaneous posterior tibial nerve stimulation in faecal incontinence.
Br J Surg
; 100(3): 330-8, 2013 Feb.
Article
in En
| MEDLINE
| ID: mdl-23300071
ABSTRACT
BACKGROUND:
Percutaneous, transcutaneous and sham transcutaneous posterior tibial nerve stimulation was compared in a prospective blinded randomized placebo-controlled trial.METHODS:
Patients who had failed conservative treatment for faecal incontinence were randomized to one of three groups group 1, percutaneous; group 2, transcutaneous; group 3, sham transcutaneous. Patients in groups 1 and 2 received 30-min sessions of posterior tibial nerve stimulation twice weekly for 6 weeks. In group 3, transcutaneous electrodes were placed in position but no stimulation was delivered. Symptoms were measured at baseline and after 6 weeks using a bowel habit diary and St Mark's continence score. Response to treatment was defined as a reduction of at least 50 per cent in weekly episodes of faecal incontinence compared with baseline.RESULTS:
Thirty patients (28 women) were enrolled. Nine of 11 patients in group 1, five of 11 in group 2 and one of eight in group 3 had a reduction of at least 50 per cent in weekly episodes of faecal incontinence at the end of the 6-week study phase (P = 0·035). Patients undergoing percutaneous nerve stimulation had a greater reduction in the number of incontinence episodes and were able to defer defaecation for a longer interval than those undergoing transcutaneous and sham stimulation. These improvements were maintained over a 6-month follow-up period.CONCLUSION:
Posterior tibial nerve stimulation has short-term benefits in treating faecal incontinence. Percutaneous therapy appears to have superior efficacy to stimulation applied by the transcutaneous route. REGISTRATION NUMBER NCT00530933 (http//www.clinicaltrials.gov).
Full text:
1
Database:
MEDLINE
Main subject:
Tibial Nerve
/
Transcutaneous Electric Nerve Stimulation
/
Fecal Incontinence
Type of study:
Clinical_trials
/
Observational_studies
Limits:
Female
/
Humans
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Male
/
Middle aged
Language:
En
Year:
2013
Type:
Article