title: Percutaneous tibial nerve stimulation for slow transit constipation: a pilot study.
abstract: OBJECTIVE
  Chronic constipation is a problem with debilitating effects on patients' quality of life. This study aimed to evaluate the effectiveness of percutaneous tibial nerve stimulation in patients with slow transit constipation.
  
  
  METHODS
  Eighteen patients (17 women, median age 47 years, range 21-74) with slow transit constipation previously failing maximal biofeedback therapy participated in the study. Patients had 12 sessions of 30 minutes of percutaneous tibial nerve stimulation. Wexner constipation score (0-30, 30 being the worst) was the primary outcome, colonic transit time, bowel diary and Patient Assessment of Constipation Quality of Life (PAC-QOL) were evaluated pre- and post-treatment.
  
  
  RESULTS
  Wexner constipation score improved significantly with treatment (median 18 pre-treatment, range 10-24, to median 14 post-treatment, range 7-22; P = 0.003). The PAC-QOL also showed significant improvement (median 2.31, range 1.36-3.61, to median 1.43, range 0.39-3.78; P = 0.008). Stool frequency increased (P = 0.048) and the use of laxatives decreased (P = 0.025). There was no change in colonic transit time (P = 0.45).
  
  
  CONCLUSIONS
  Percutaneous tibial nerve stimulation has potential as an affordable and minimally invasive treatment for slow transit constipation.
authors.affiliation: St Mark's Hospital, Harrow, UK. brigitte.collins@nhs.net
authors.forename: B
authors.initials: B
authors.lastname: Collins
authors.forename: C
authors.initials: C
authors.lastname: Norton
authors.forename: Y
authors.initials: Y
authors.lastname: Maeda
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D013979:Tibial Nerve; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome