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Randomized controlled trial of percutaneous versus transcutaneous posterior tibial nerve stimulation in faecal incontinence.
MedLine Citation:
PMID:  23300071     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous, transcutaneous and sham transcutaneous posterior tibial nerve stimulation was compared in a prospective blinded randomized placebo-controlled trial.
METHODS: Patients who had failed conservative treatment for faecal incontinence were randomized to one of three groups: group 1, percutaneous; group 2, transcutaneous; group 3, sham transcutaneous. Patients in groups 1 and 2 received 30-min sessions of posterior tibial nerve stimulation twice weekly for 6 weeks. In group 3, transcutaneous electrodes were placed in position but no stimulation was delivered. Symptoms were measured at baseline and after 6 weeks using a bowel habit diary and St Mark's continence score. Response to treatment was defined as a reduction of at least 50 per cent in weekly episodes of faecal incontinence compared with baseline.
RESULTS: Thirty patients (28 women) were enrolled. Nine of 11 patients in group 1, five of 11 in group 2 and one of eight in group 3 had a reduction of at least 50 per cent in weekly episodes of faecal incontinence at the end of the 6-week study phase (P = 0·035). Patients undergoing percutaneous nerve stimulation had a greater reduction in the number of incontinence episodes and were able to defer defaecation for a longer interval than those undergoing transcutaneous and sham stimulation. These improvements were maintained over a 6-month follow-up period.
CONCLUSION: Posterior tibial nerve stimulation has short-term benefits in treating faecal incontinence. Percutaneous therapy appears to have superior efficacy to stimulation applied by the transcutaneous route. Registration number: NCT00530933 (http://www.clinicaltrials.gov). Copyright © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors:
A T George; K Kalmar; S Sala; K Kopanakis; A Panarese; T C Dudding; J R Hollingshead; R J Nicholls; C J Vaizey
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  100     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  330-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Physiology Unit, St Mark's Hospital, Watford Road, Harrow HA1 3UJ, UK. anilthomasgeorge@hotmail.com.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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