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Sacral transcutaneous electrical nerve stimulation in the treatment of idiopathic faecal incontinence
S S B Chew1, R Sundaraj, W Adams
1Department of Surgery, Norwest Private Hospital, Penrith, New South Wales, Australia. simon.chew@simonchew.com.au
Aim:
The aim of this study was to investigate the potential use of S3 transcutaneous electrical nerve stimulation (TENS) in the treatment of idiopathic faecal incontinence.
Method:
Seventeen patients were treated by S3 TENS 2 h a day for 3 months. The outcome was evaluated by faecal incontinence severity index (FISI), faecal incontinence quality of life scale (FIQOL), 7-day bowel diary, anorectal physiology, patients' self-reported impression of improvement, bowel control and satisfaction with treatment on a visual analogue scale.
Results:
Seventeen patients (13 women) of mean age 67.2 years (52-80) were followed up for a mean of 19.7 months. The FISI improved in 69% after 3 months of TENS (P < 0.01), and all components of FIQOL improved. The number of incontinent episodes per week fell for incontinence to gas and stool (solid and/or liquid). There was no significant difference in the maximum resting pressure and squeeze pressure, but the mean rectal volume of first sensation (12.1 ml, P = 0.027) and first urge (25.0 ml, P = 0.054) fell, and the maximum tolerable volume (16.0 ml, P = 0.679) rose. The satisfaction score was ≥ 6/10 in all patients. Fifteen (88%) scored ≥ 6/10 for bowel control, and all patients scored ≥ 2 (scale: -5 to +5) for their impression of improvement.
Conclusion:
S3 transcutaneous electrical nerve stimulation seems to be a promising noninvasive method to treat faecal incontinence. However, further study is required.
