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Percutaneous tibial nerve stimulation vs sacral nerve stimulation for faecal incontinence: a comparative case-matched
S Al Asari1, G Meurette, S Mantoo
1Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Nantes, France.
Summary
Posterior tibial nerve stimulation (PTNS) offers a simpler, cheaper, and less invasive alternative to sacral nerve stimulation (SNS) for treating faecal incontinence, with similar short-term outcomes.
Area of Science:
- Urology
- Colorectal Surgery
- Neuromodulation
Background:
- Chronic severe faecal incontinence presents a significant challenge in conservative treatment failure.
- Neurostimulation techniques like PTNS and SNS are explored for refractory cases.
Purpose of the Study:
- To evaluate the initial clinical experience with PTNS for faecal incontinence.
- To compare the efficacy and safety of PTNS against SNS in a single-centre cohort.
Main Methods:
- Retrospective review of a prospectively collected database (May 2009 - Dec 2010).
- 78 patients with chronic severe faecal incontinence underwent either PTNS (n=21) or SNS (n=57).
- Short-term outcomes assessed using Wexner and Fecal Incontinence Quality of Life (FIQL) scores.
Main Results:
- No significant differences in Wexner or FIQL scores between PTNS and SNS groups at 6 and 12 months.
- Similar rates of achieving at least 50% improvement in Wexner score at 6 and 12 months.
- PTNS group reported no adverse effects, while SNS had a 5% wound infection rate and 32% failure at peripheral nerve evaluation.
Conclusions:
- PTNS is a viable, less invasive, and cost-effective short-term treatment for faecal incontinence post-conservative failure.
- PTNS demonstrates comparable efficacy to SNS with a favorable safety profile.
- The study supports PTNS as a valuable option in the neuromodulation armamentarium for faecal incontinence.
