Year 2018 / Volume 110 / Number 9
Review
Posterior tibial nerve stimulation in the treatment of fecal incontinence: a systematic review

577-588

DOI: 10.17235/reed.2018.5007/2017

Rubén Arroyo Fernández, Juan Avendaño Coy, Sara Ando Lafuente, M.ª Teresa Martín Correa, Asunción Ferri Morales,

Abstract
Fecal incontinence severely impacts on quality of life, causing stigmatization and social exclusion. Posterior tibial nerve stimulation (PTNS) is one technique used for treatment. This systematic review aims to assess the effectiveness of PTNS for the treatment of fecal incontinence. A literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration. Pubmed, Scopus, Web of Knowledge and PEDro databases were searched for both randomized clinical trials and cases series. The outcome variables were treatment effectiveness, severity of incontinence and quality of life; all were measured in the short, mid and long-term after performing both percutaneous and transcutaneous PTNS. Twenty-three studies met the selection criteria. Two clinical trials found significant differences in treatment effectiveness compared to the placebo response. Fifteen cases series observed significant differences in terms of effectiveness, severity and quality of life. All clinical trials achieved a reduction in the number of incontinence episodes and an increase in the deferral time for defecation. Optimal results were achieved by interventions consisting of one or two weekly sessions of a 30-60 minutes duration and the use of pulse widths of 200 µs and frequencies of 10-20 Hz. Percutaneous stimulation did not demonstrate better results compared to transcutaneous application. PTNS is an effective technique for the treatment of fecal incontinence, although long-term interventions are required in order to prolong its effects in the long-term.
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Arroyo Fernández R, Avendaño Coy J, Ando Lafuente S, Martín Correa M, Ferri Morales A. Posterior tibial nerve stimulation in the treatment of fecal incontinence: a systematic review. 5007/2017


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Publication history

Received: 13/04/2017

Accepted: 19/03/2018

Online First: 31/08/2018

Published: 31/08/2018

Article revision time: 335 days

Article Online First time: 505 days

Article editing time: 505 days


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