title: Percutaneous tibial nerve stimulation for fecal incontinence:  a video demonstration.
abstract: BACKGROUND
  Fecal incontinence is an increasingly common condition with significant negative impact on quality on life and health care resources. It frequently presents a therapeutic challenge to clinicians. Emerging evidence suggests that percutaneous tibial nerve stimulation is an effective treatment for fecal incontinence with the added benefit of being minimally invasive and cost effective.
  
  
  METHODS
  Pursuant to the preliminary report of our early experience of percutaneous tibial nerve stimulation in patients with fecal incontinence published in this journal in 2010, in this dynamic article, we now describe and demonstrate the actual technique that can be performed in a nurse-led clinic or outpatient or community setting.
  
  
  CONCLUSIONS
  Percutaneous tibial nerve stimulation is a technically simple procedure that can potentially be performed in an outpatient or community setting. The overall early success rate of 68% following its use reported by our unit compares favorably with the success rate following other forms of neuromodulation, including sacral nerve stimulation. When completed, our long-term outcome data will provide further information on the efficacy of tibial nerve stimulation in a larger cohort of patients (n > 100). Future studies, including our currently planned randomized controlled trial of percutaneous tibial nerve stimulation vs sham stimulation, will provide controlled efficacy data and may provide information on its exact mechanism of action.
authors.affiliation: Academic Surgical Unit, Centre for Digestive Diseases, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London, Whitechapel, London, UK. alex007@doctors.org.uk
authors.forename: Alexander
authors.initials: A
authors.lastname: Hotouras
authors.forename: Marion
authors.initials: M
authors.lastname: Allison
authors.forename: Ann
authors.initials: A
authors.lastname: Currie
authors.forename: Charles H
authors.initials: CH
authors.lastname: Knowles
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Chan
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Thaha
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D013979:Tibial Nerve / Q000502:physiology*; D016896:Treatment Outcome