Biomaterial Database

Posterior tibial nerve stimulation for fecal incontinence: where are we? 2013

Anil Thomas George, and Rudra Krishna Maitra, and Charles Maxwell-Armstrong

Anil Thomas George, Colorectal Surgery, St Mark's Hospital, London HA1 3UJ, United Kingdom.

Neurostimulation remains the mainstay of treatment for patients with faecal incontinence who fails to respond to available conservative measures. Sacral nerve stimulation (SNS) is the main form of neurostimulation that is in use today. Posterior tibial nerve stimulation (PTNS)--both the percutaneous and the transcutaneous routes--remains a relatively new entry in neurostimulation. Though in its infancy, PTNS holds promise to be an effective, patient friendly, safe and cheap treatment. However, presently PTNS only appears to have a minor role with SNS having the limelight in treating patients with faecal incontinence. This seems to have arisen as the strong, uniform and evidence based data on SNS remains to have been unchallenged yet by the weak, disjointed and unsupported evidence for both percutaneous and transcutaneous PTNS. The use of PTNS is slowly gaining acceptance. However, several questions remain unanswered in the delivery of PTNS. These have raised dilemmas which as long as they remain unsolved can considerably weaken the argument that PTNS could offer a viable alternative to SNS. This paper reviews available information on PTNS and focuses on these dilemmas in the light of existing evidence.

UI	MeSH Term	Description	Entries
D007422	Intestines	The section of the alimentary canal from the STOMACH to the ANAL CANAL. It includes the LARGE INTESTINE and SMALL INTESTINE.	Intestine
D003672	Defecation	The normal process of elimination of fecal material from the RECTUM.	Bowel Function,Bowel Movement,Bowel Functions,Bowel Movements,Defecations
D004561	Transcutaneous Electric Nerve Stimulation	The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.	Analgesic Cutaneous Electrostimulation,Electric Stimulation, Transcutaneous,Electroanalgesia,Percutaneous Electric Nerve Stimulation,TENS,Transdermal Electrostimulation,Electrical Stimulation, Transcutaneous,Percutaneous Electrical Nerve Stimulation,Percutaneous Electrical Neuromodulation,Percutaneous Neuromodulation Therapy,Transcutaneous Electrical Nerve Stimulation,Transcutaneous Nerve Stimulation,Cutaneous Electrostimulation, Analgesic,Electrical Neuromodulation, Percutaneous,Electrical Neuromodulations, Percutaneous,Electroanalgesias,Electrostimulation, Analgesic Cutaneous,Electrostimulation, Transdermal,Nerve Stimulation, Transcutaneous,Neuromodulation Therapy, Percutaneous,Neuromodulation, Percutaneous Electrical,Neuromodulations, Percutaneous Electrical,Percutaneous Electrical Neuromodulations,Percutaneous Neuromodulation Therapies,Stimulation, Transcutaneous Electric,Stimulation, Transcutaneous Nerve,Therapy, Percutaneous Neuromodulation,Transcutaneous Electric Stimulation,Transcutaneous Electrical Stimulation
D005242	Fecal Incontinence	Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus.	Bowel Incontinence,Fecal Soiling,Incontinence, Bowel,Incontinence, Fecal,Soilings, Fecal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013979	Tibial Nerve	The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot.	Medial Plantar Nerve,Posterior Tibial Nerve,Medial Plantar Nerves,Nerve, Medial Plantar,Nerve, Posterior Tibial,Nerve, Tibial,Nerves, Medial Plantar,Nerves, Posterior Tibial,Nerves, Tibial,Plantar Nerve, Medial,Plantar Nerves, Medial,Posterior Tibial Nerves,Tibial Nerve, Posterior,Tibial Nerves,Tibial Nerves, Posterior
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017048	Health Care Costs	The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.	Medical Care Costs,Treatment Costs,Costs, Medical Care,Health Costs,Healthcare Costs,Cost, Health,Cost, Health Care,Cost, Healthcare,Cost, Medical Care,Cost, Treatment,Costs, Health,Costs, Health Care,Costs, Healthcare,Costs, Treatment,Health Care Cost,Health Cost,Healthcare Cost,Medical Care Cost,Treatment Cost
D020127	Recovery of Function	A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.	Function Recoveries,Function Recovery