Percutaneous posterior tibial nerve stimulation (PPTNS) in faecal incontinence associated with an anal sphincter lesion: results of a prospective study.

PURPOSE: Establish the efficacy of posterior tibial nerve stimulation in treating faecal incontinence associated to sphincter defect. METHODS: Prospective study that included patients with faecal incontinence associated to sphincter lesions between 90 and 180°. Clinical anamnesis, physical examination, reverse visual analogic scale, incontinence diary and Wexner score were recorded at baseline and 6 months. Anal manometry was realized at baseline and 6 months. Subjects underwent one 30-min session every week for 12 consecutive weeks and was continued with 6 additional sessions every 2 weeks. RESULTS: Sixteen patients were analysed, 15 women and 1 men, with a mean age of 56.5 years. The incontinence were obstetric origin (50%) and perineal surgeries (50%). Four patients who did not continue with the second stage. Referring to the retention time, at baseline 12 patients (75%) did not bear even 1 min. At 6 months the retention time was <1 min in only 2 patients (p = 0.008). Median Wexner baseline values were 10; at 6 months decrease to 5 (p = 0.006). The visual analogical scale (VAS) increased from 6 to 7.5 (p > 0.05). After 6 months, maximum resting pressure increased from 40.9 to 51 mmHg (p < 0.001) and maximum squeeze pressure from 82.5 to 94 mmHg (p < 0.001). CONCLUSION: PTNS is an effective treatment for faecal incontinence associated to sphincter lesions because the number of incontinence episodes per week, the Wexner Score, the ability to defer defaecation and the manometric determinations improved significantly.