Transcutaneous tibial nerve stimulation for the treatment of faecal incontinence: results of a prospective study

2014 ◽  
Vol 21 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Ieva Stundienė ◽  
Paulius Žeromskas ◽  
Jonas Valantinas
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Faecal Incontinence ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Cleveland Clinic ◽  
Life Questionnaire ◽  
Incontinence Score ◽  
Tibial Nerve Stimulation

Background. Transcutaneous tibial nerve stimulation is a simple, non-invasive treatment, which can be used to treat faecal incontinence. Optimal treatment regimen is not known and various stimulation regimens are used in different centers. The aim of this prospective study was to evaluate the efficacy of twice weekly transcutaneous tibial nerve stimulation for faecal incontinence patients, who have failed to respond to maximal conservative treatment. Material and methods. Twenty patients with faecal incontinence resistant to maximal conservative therapy were treated with transcutaneous posterior tibial nerve stimulation twice a week for six weeks. The number of the bowel movements per two weeks and the Cleveland Clinic Florida Feacal Incontinence Score were assessed before and after the treatment. The quality of life was estimated using the Faecal Incontinence Quality of Life questionnaire and the Gastrointestinal Quality of Life Index. Results. Effect was seen in 55% of patients. Two-week faecal incontinence episodes decreased from median 4  (2–84) to 2  (0–56) (p = 0.002). The mean Cleveland Clinic Florida Faecal Incontinence score improved from 10.9 ± 4.34 to 7.8 ± 3.96 (p = 0.002). The quality of life improved significantly after the treatment. The therapy was well tolerated and no participant experienced any adverse event. Conclusions. Transcutaneous tibial nerve stimulation twice a week for 6 weeks may be efficacious in patients with faecal incontinence, who have failed to respond to maximal conservative treatments.

scholarly journals Assessing Rectocele Depth and Its Association with Symptoms of Pelvic Floor Disorders Using Transperineal Ultrasound

2021 ◽  
Author(s):  
Hongyoon Jeong ◽  
Duk Hoon Park ◽  
Daeyoun Won ◽  
Jong Kyun Lee
Keyword(s):  
Quality Of Life ◽  
Pelvic Floor ◽  
Faecal Incontinence ◽  
Pelvic Floor Disorders ◽  
Clinical Symptoms ◽  
Cleveland Clinic ◽  
Severity Index ◽  
Transperineal Ultrasound ◽  
Incontinence Score

Abstract Aim We investigated the clinical features of symptomatic rectoceles, as measured by transperineal ultrasound (TPUS), and evaluated the association between rectocele size and the clinical symptoms of pelvic floor disorders. Method This was a retrospective study using data obtained at a pelvic floor centre between August 2020 and January 2021. A total of 125 patients with defaecation disorders, such as constipation and faecal incontinence, were included. The preoperative questionnaire included the Cleveland Clinic Constipation Scoring System (CCCS, Wexner constipation score), Cleveland Clinic Incontinence Score (CCIS, Wexner incontinence score), faecal incontinence severity index (FISI), and faecal incontinence quality of life (FIQOL) scale. The size of the rectocele was measured on the trans-perineal 2D images. Patients were assigned to three groups based on rectocele size: no rectocele (<10 mm), ≥10 mm rectocele, and ≥15 mm rectocele. Results In the study population, 43 participants (34.4%) had no rectocele, 50 (40.0%) had ≥10 mm rectocele, and 32 (25.6%) had ≥15 mm rectocele. From the no rectocele to ≥15 mm rectocele group, the scores for the symptoms of incontinence and constipation increased, and the quality of life worsened. The CCIS (6.00±4.95 vs 8.62±5.77 vs 11.08±5.63, P = 0.004), FIQOL (13.72±4.19 vs 13.42±4.35 vs 10.38±3.88, P = 0.006), FISI (18.83±17.67 vs 25.15±17.34 vs 33.42±15.49, P = 0.010), and CCCS (7.50±6.26 vs 8.65±5.31 vs 13.11±5.90, P = 0.006), respectively. Conclusion The TPUS was a valuable method for the anatomical evaluation of symptomatic rectocele. The larger the size of the symptomatic rectocele measured using TPUS, the more severe the clinical symptoms.

scholarly journals Comparison of the Effect of Percutaneous Tibial Nerve Stimulation (PTNS) with Medical Treatment in Patients with Overactive Bladder

2021 ◽  
pp. 365-373
Author(s):  
Mohammadreza Nikoo ◽  
Lobat Majidi ◽  
Amirmohammad Heidari ◽  
Babak Jafarvand ◽  
Danial Aghabozorgi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Overactive Bladder ◽  
Drug Treatment ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation ◽  
The Mean

Introduction: Overactive bladder (OAB) is a common problem that involves therapeutic challenges. Therefore, finding new and effective treatment modalities in these patients is essential. The aim of this study was to compare the therapeutic effect of percutaneous tibial nerve stimulation (PTNS) with drug therapy in patients with OAB. Methods: In this randomized controlled clinical trial, 74 patients with OAB were randomly divided into two groups: PTNS (twice a week for 12 weeks) and drug treatment (Solifenacin 10 mg daily for 12 weeks). OAB Symptom Score, q-OAB and Health-Related Quality of Life Questionnaire (HRQL) were completed and then compared at the beginning and end of the study for the two groups. Findings were analyzed using SPSS software version 20. Results: The drug intervention group consisted of 33 (89.2%) females and 4 males (10.81%), and PTNS group consisted of 31 females (83.8%) and 6 males (16.21%), (P = 0.496). Mean quality of life score, mean OABSS score, OAB screening score and urinary incontinence in both groups before the intervention did not show a statistically significant difference. After treatment, the mean quality of life in both groups increased significantly compared to before the intervention, but this increase was significantly higher in PTNS when compared with other group (74.2±6.9 vs. 68.9± 7.3). The mean OABSS score, OAB screening score and urinary incontinence in both groups decreased significantly compared to before treatment, but the mean OABSS score and OAB and urinary incontinence screening scores showed a significant decrease in PTNS group compared to drug treatment. Conclusion: Based on the findings, PTNS was found to be more effective than drug treatment in increasing the quality of life and controlling symptoms of OAB.

Correlation between quality of life and voiding variables in patients treated with percutaneous tibial nerve stimulation

2006 ◽  
Vol 97 (1) ◽  
pp. 113-116 ◽  
Author(s):  
FLOOR VAN DER PAL ◽  
MICHAEL R. VAN BALKEN ◽  
JOHN P.F.A. HEESAKKERS ◽  
FRANS M.J. DEBRUYNE ◽  
LAMBERTUS A.L.M. KIEMENEY ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation

scholarly journals ELECtric Tibial nerve stimulation to Reduce Incontinence in Care homes: protocol for the ELECTRIC randomised trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Booth ◽  
L. Aucott ◽  
S. Cotton ◽  
C. Goodman ◽  
S. Hagen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Low Cost ◽  
Care Homes ◽  
Sham Stimulation ◽  
Non Invasive ◽  
Tibial Nerve Stimulation

Abstract Background Urinary incontinence (UI) is highly prevalent in nursing and residential care homes (CHs) and profoundly impacts on residents’ dignity and quality of life. CHs predominantly use absorbent pads to contain UI rather than actively treat the condition. Transcutaneous posterior tibial nerve stimulation (TPTNS) is a non-invasive, safe and low-cost intervention with demonstrated effectiveness for reducing UI in adults. However, the effectiveness of TPTNS to treat UI in older adults living in CHs is not known. The ELECTRIC trial aims to establish if a programme of TPTNS is a clinically effective treatment for UI in CH residents and investigate the associated costs and consequences. Methods This is a pragmatic, multicentre, placebo-controlled, randomised parallel-group trial comparing the effectiveness of TPTNS (target n = 250) with sham stimulation (target n = 250) in reducing volume of UI in CH residents. CH residents (men and women) with self- or staff-reported UI of more than once per week are eligible to take part, including those with cognitive impairment. Outcomes will be measured at 6, 12 and 18 weeks post randomisation using the following measures: 24-h Pad Weight Tests, post void residual urine (bladder scans), Patient Perception of Bladder Condition, Minnesota Toileting Skills Questionnaire and Dementia Quality of Life. Economic evaluation based on a bespoke Resource Use Questionnaire will assess the costs of providing a programme of TPTNS. A concurrent process evaluation will investigate fidelity to the intervention and influencing factors, and qualitative interviews will explore the experiences of TPTNS from the perspective of CH residents, family members, CH staff and managers. Discussion TPTNS is a non-invasive intervention that has demonstrated effectiveness in reducing UI in adults. The ELECTRIC trial will involve CH staff delivering TPTNS to residents and establish whether TPTNS is more effective than sham stimulation for reducing the volume of UI in CH residents. Should TPTNS be shown to be an effective and acceptable treatment for UI in older adults in CHs, it will provide a safe, low-cost and dignified alternative to the current standard approach of containment and medication. Trial registration ClinicalTrials.gov, NCT03248362. Registered on 14 August 2017. ISRCTN, ISRCTN98415244. Registered on 25 April 2018. https://www.isrctn.com/.

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