Chronic Posterior Tibial Nerve Transcutaneous Electrical Nerve Stimulation (TENS) to Treat Fecal Incontinence (FI)

Overview

Journal Int J Colorectal Dis

Specialties Gastroenterology
General Surgery

Date 2010 Jun 16

PMID 20549220

Citations 13

Authors

Marianne Eleouet

Laurent Siproudhis

Nelly Guillou

Jocelyne Le Couedic

Guillaume Bouguen

Jean Francois Bretagne

Affiliations

Soon will be listed here.

Abstract

Aim: Transcutaneous electrical nerve stimulation (TENS) is a possible alternative to sacral nerve stimulation because the neurophysiologic targets might be similar but the former method is non-invasive and cheaper. The aim of the study was to assess both symptom and quality of life (QoL) improvements in patients suffering from severe FI.

Methods: Thirty two patients (M/F, 30/2; age, 61 +/- 13 years) were enrolled in a pilot trial because they suffered from a severe and stable FI (Cleveland Score14.5 +/- 2.8 [11-20]) for a long duration (95 +/- 91 months). TENS was delivered 20 min bis in die at home (Schwa Medico, P3). Assessment was realized at 1, 3, and 6 months with both semi-directive and self-administered questionnaires. Main endpoint was the quantified success rate after 1 month of follow-up.

Results: Mean subjective improvement was 26 +/- 30%: 20 (63%) patients reported some degree of improvement and 10 (32%) at least a 25% improvement in fecal incontinence. The Cleveland score significantly decreased at 1 (11 +/- 4; p < 0.001), 3 (11 +/- 5; p < 0.001), and 6 (10 +/- 5; p < 0.001) months. All subscales of QoL were significantly improved after a 3-month period of stimulation. However, constipation score and number of pads did not change. There was no adverse event.

Conclusion: TENS provides slight improvement in FI. This justifies both neurophysiology assessment and randomized controlled studies before further diffusion of the technique.

Citing Articles

Tibial nerve electrical stimulation for fecal incontinence: a systematic review and meta-analysis.

Jin Q, Zhu Y, Yin P, Li X Updates Surg. 2022; 75(5):1059-1070.

PMID: 36525234 DOI: 10.1007/s13304-022-01444-w.

Effects of transcutaneous electrical nerve stimulation on rats with post-operative ileus.

Balas S, Yilmaz K, Tokgoz S, Saydam M, Yanik H, Onder E Ulus Travma Acil Cerrahi Derg. 2022; 28(10):1382-1388.

PMID: 36169472 PMC: 10277373. DOI: 10.14744/tjtes.2021.87767.

Kegel Exercises, Biofeedback, Electrostimulation, and Peripheral Neuromodulation Improve Clinical Symptoms of Fecal Incontinence and Affect Specific Physiological Targets: An Randomized Controlled Trial.

Mundet L, Rofes L, Ortega O, Cabib C, Clave P J Neurogastroenterol Motil. 2020; 27(1):108-118.

PMID: 33109777 PMC: 7786087. DOI: 10.5056/jnm20013.

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review.

DAmico F, Wexner S, Vaizey C, Gouynou C, Danese S, Peyrin-Biroulet L United European Gastroenterol J. 2020; 8(8):886-922.

PMID: 32677555 PMC: 7707876. DOI: 10.1177/2050640620943699.

Efficacy of Bilateral Transcutaneous Posterior Tibial Nerve Stimulation for Fecal Incontinence.

Dedemadi G, Takano S Perm J. 2018; 22:17-231.

PMID: 30028671 PMC: 6054409. DOI: 10.7812/TPP/17-231.

References

Vaizey C, Carapeti E, Cahill J, Kamm M . Prospective comparison of faecal incontinence grading systems. Gut. 1998; 44(1):77-80. PMC: 1760067. DOI: 10.1136/gut.44.1.77. View

Nakamura M, Sakurai T, Tsujimoto Y, Tada Y . [Transcutaneous electrical stimulation for the control of frequency and urge incontinence]. Hinyokika Kiyo. 1983; 29(9):1053-9. View

Rullier E, Zerbib F, Marrel A, Amouretti M, Lehur P . Validation of the French version of the Fecal Incontinence Quality-of-Life (FIQL) scale. Gastroenterol Clin Biol. 2004; 28(6-7 Pt 1):562-8. DOI: 10.1016/s0399-8320(04)95012-9. View

van der Pal F, van Balken M, Heesakkers J, Debruyne F, Bemelmans B . Percutaneous tibial nerve stimulation in the treatment of refractory overactive bladder syndrome: is maintenance treatment necessary?. BJU Int. 2006; 97(3):547-50. DOI: 10.1111/j.1464-410X.2006.06055.x. View

Chang P . Urodynamic studies in acupuncture for women with frequency, urgency and dysuria. J Urol. 1988; 140(3):563-6. DOI: 10.1016/s0022-5347(17)41719-8. View

Siproudhis L, Pigot F, Godeberge P, Damon H, Soudan D, Bigard M . Defecation disorders: a French population survey. Dis Colon Rectum. 2005; 49(2):219-27. DOI: 10.1007/s10350-005-0249-8. View

Shafik A, Ahmed I, El-Sibai O, Mostafa R . Percutaneous peripheral neuromodulation in the treatment of fecal incontinence. Eur Surg Res. 2003; 35(2):103-7. DOI: 10.1159/000069399. View

van Balken M, Vandoninck V, Gisolf K, Vergunst H, Kiemeney L, Debruyne F . Posterior tibial nerve stimulation as neuromodulative treatment of lower urinary tract dysfunction. J Urol. 2001; 166(3):914-8. DOI: 10.1097/00005392-200109000-00025. View

Damon H, Dumas P, Mion F . Impact of anal incontinence and chronic constipation on quality of life. Gastroenterol Clin Biol. 2004; 28(1):16-20. DOI: 10.1016/s0399-8320(04)94835-x. View

10.

Bosch J . Electrical neuromodulatory therapy in female voiding dysfunction. BJU Int. 2006; 98 Suppl 1:43-8. DOI: 10.1111/j.1464-410X.2006.06316.x. View

11.

Nuhoglu B, Fidan V, Ayyildiz A, Ersoy E, Germiyanoglu C . Stoller afferent nerve stimulation in woman with therapy resistant over active bladder; a 1-year follow up. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 17(3):204-7. DOI: 10.1007/s00192-005-1370-x. View

12.

Amarenco G, Sheikh Ismael S, Even-Schneider A, Raibaut P, Demaille-Wlodyka S, Parratte B . Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder. J Urol. 2003; 169(6):2210-5. DOI: 10.1097/01.ju.0000067446.17576.bd. View

13.

Malm-Buatsi E, Nepple K, Boyt M, Austin J, Cooper C . Efficacy of transcutaneous electrical nerve stimulation in children with overactive bladder refractory to pharmacotherapy. Urology. 2007; 70(5):980-3. DOI: 10.1016/j.urology.2007.06.1109. View

14.

Queralto M, Portier G, Cabarrot P, Bonnaud G, Chotard J, Nadrigny M . Preliminary results of peripheral transcutaneous neuromodulation in the treatment of idiopathic fecal incontinence. Int J Colorectal Dis. 2005; 21(7):670-2. DOI: 10.1007/s00384-005-0068-3. View

15.

van Balken M, Vergunst H, Bemelmans B . The use of electrical devices for the treatment of bladder dysfunction: a review of methods. J Urol. 2004; 172(3):846-51. DOI: 10.1097/01.ju.0000134418.21959.98. View