title: Efficacy and quality of life after transcutaneous posterior tibial neuromodulation for faecal incontinence.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of transcutaneous neuromodulation of the posterior tibial nerve for faecal incontinence and to assess quality of life after the procedure.
  
  
  METHODS
  A prospective non-randomized cohort study was conducted in a tertiary centre from September 2010 to May 2013. All patients with faecal incontinence who met the inclusion criteria were included and were treated as outpatients during a 3-month period by unilateral neuromodulation of the posterior tibial nerve. The patients were followed 3-monthly for 1 year. Severity scales, a bowel diary and quality of life scales were evaluated prospectively before and after treatment.
  
  
  RESULTS
  Twenty-seven patients of median age 67 (interquartile range 60-69) years and a male to female ratio of 1/6 were included. Faecal incontinence was for solid stools in 48.1% of patients with urgency in 55.6%. About one-third (34.6%) had a sphincter defect on ultrasound and reduction of anal canal pressure in 85.2%. There was a significant improvement in episodes of incontinence on the Wexner score and visual analogue scale assessment and a decrease in the number of episodes of incontinence per unit time. The Fecal Incontinence Quality of Life score was improved at the end of the follow-up. No adverse effects were observed. The cost of the treatment was €135 per patient.
  
  
  CONCLUSIONS
  Transcutaneous posterior tibial nerve neuromodulation provides good treatment for faecal incontinence in terms of efficacy and quality of life.
authors.affiliation: Surgery Department, Alcorcon University Hospital, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Jiménez-Toscano
authors.affiliation: Surgery Department, Alcorcon University Hospital, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Vega
authors.affiliation: Surgery Department, Alcorcon University Hospital, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Fernandez-Cebrián
authors.affiliation: Physiotherapy Department, Alcorcon University Hospital, Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Valle Martín
authors.affiliation: Surgery Department, Alcorcon University Hospital, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Jiménez-Almonacid
authors.affiliation: Surgery Department, Alcorcon University Hospital, Madrid, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Rueda Orgaz
mesh_terms: D000368:Aged; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013979:Tibial Nerve; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects / Q000191:economics; D016896:Treatment Outcome
keywords: Faecal incontinence; neuromodulation; quality of life; tibial nerve