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Evaluation of the anorectal motor response after percutaneous stimulation of the posterior tibial nerve in patients with fecal incontinence

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Abstract

Background

The effect of posterior tibial nerve stimulation (PTNS) on the mechanisms of anal continence has not been fully demonstrated. The aim of this study was to assess the anal manometric response after percutaneous PTNS in patients with fecal incontinence (FI).

Methods

This was a prospective study in patients with FI undergoing 1 weekly session of percutaneous PTNS for 8 weeks. A clinical assessment (Wexner scale) and a complete study of up to 22 manometric parameters were carried out prior to treatment and 2–4 weeks after the end of treatment.

Results

A total of 32 patients were evaluated. After therapy, there was a decrease in the average Wexner score [12.6 (± 5.2) to 9.5 (± 5.2) (P < 0.005)] and an increase in the “anal canal length at rest” [4.55 (± 0.60) to 4.95 (± 0.21) P = 0.004], without observing variations in other manometric parameters. The decrease in the Wexner score was significantly correlated with an increase in the “pressure at 5 cm at rest” after therapy (r = 0.464 P = 0.030).

Conclusions

In our study, PTNS was associated with a significant decrease in the Wexner score and with an increase in the functional length of the anal canal at rest. The improvement in the Wexner scale was correlated with an increase in pressure at rest in the theoretical area of the anorectal junction.

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Authors and Affiliations

  1. Servicio de Cirugía General y del Aparato Digestivo, Hospital de Sagunto, Valencia, Spain

    R. Rodríguez Carrillo, M. D. Ruiz Carmona, R. Alós Company, A. Frangi Caregnato, M. Alarcón Iranzo, A. Solana Bueno & R. Lozoya Trujillo

  2. Servicio de Cirugía General y del Aparato Digestivo, Hospital la Fe, Valencia, Spain

    E. García-Granero Ximénez

Authors
  1. R. Rodríguez Carrillo
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  2. M. D. Ruiz Carmona
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  3. R. Alós Company
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  4. A. Frangi Caregnato
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  5. M. Alarcón Iranzo
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  6. A. Solana Bueno
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  7. R. Lozoya Trujillo
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  8. E. García-Granero Ximénez
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Correspondence to R. Rodríguez Carrillo.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Clinical Research Ethics Committee of the Hospital of Sagunto.

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Informed consent was obtained from all participants included in the study

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Rodríguez Carrillo, R., Ruiz Carmona, M.D., Alós Company, R. et al. Evaluation of the anorectal motor response after percutaneous stimulation of the posterior tibial nerve in patients with fecal incontinence. Tech Coloproctol 23, 987–992 (2019). https://doi.org/10.1007/s10151-019-02092-w

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  • DOI: https://doi.org/10.1007/s10151-019-02092-w

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