PT  - JOURNAL ARTICLE
AU  - George, A
AU  - Kalmar, K
AU  - Sala, S
AU  - Kokopoulis, K
AU  - Panarese, A
AU  - Nicholls, R J
AU  - Vaizey, C J
TI  - A prospective single blinded placebo controlled study into the role of percutaneous and transcutaneous tibial nerve stimulation for faecal incontinence
AID  - 10.1136/gut.2011.239301.334
DP  - 2011 Apr 01
TA  - Gut
PG  - A157--A158
VI  - 60
IP  - Suppl 1
4099  - http://gut.bmj.com/content/60/Suppl_1/A157.2.short
4100  - http://gut.bmj.com/content/60/Suppl_1/A157.2.full
SO  - Gut2011 Apr 01; 60
AB  - Introduction Posterior tibial nerve stimulation (PTNS) is a safe and effective treatment1 2 for faecal incontinence (FI) but it is not known whether percutaneous or transcutaneous routes of stimulation are better. The efficacy of PTNS was assessed in a prospective randomised placebo-controlled trial. Methods Patients who had failed conservative treatment for FI were blinded and randomised to one of the three forms of stimulation: Group 1: Percutaneous, Group 2: Transcutaneous, Group 3: Sham transcutaneous. All patients had a 2 week baseline assessment of symptoms. Patients in Group 1 and Group 2 received 30 min sessions of PTNS twice weekly for 6 weeks. In Group 3 transcutaneous electrodes were placed but no stimulation was delivered. All patients were assessed blind at 6 weeks; unblinded and followed up after a further 1 month to assess symptoms. Treatment success was defined as > 50% reduction in weekly episodes of faecal incontinence following the 6 weeks of PTNS when compared to baseline symptoms. Results Thirty patients (M:F 2:28) were included in the study. Nine (82%) of 11 patients in Group 1, 5 (45%) of 11 in Group 2 and 1 (12.5%) of 8 in Group 3 had a more than 50% reduction in weekly episodes of FI at the end of the 6 week study phase (table 1). Patients also showed an improvement in their ability to defer defecation and in the St Mark's Continence scores pre and post treatment. View this table:Table 1 PWE-071 The improved continence observed in the above patients of all the 3 groups was sustained at the 1 month post study follow-up. There were no complications observed in any patient. Conclusion This study demonstrates the efficacy of PTNS as a treatment option for FI in the short term.