title: Sacral nerve stimulation versus percutaneous posterior tibial nerve stimulation in the treatment of severe fecal incontinence in men.
abstract: BACKGROUND
  Sacral nerve stimulation and percutaneous posterior tibial nerve stimulation have been described previously as effective treatments for fecal incontinence. Nevertheless, there does not exist any study that compares the efficiency of both. The aim of this study was to compare the use of SNS and PPTNS in males with FI.
  
  
  METHODS
  We conducted a prospective cohort study on men with FI treated with SNS or PTNS in the Coloproctology Unit of the University General Hospital of Elche and Reina Sofia of Murcia between January 2010 and December 2011. Preoperative assessment included physical examination, anorectal manometry, and anal endosonography. Anal continence was evaluated using the Wexner continence grading system. Quality of life was evaluated using the Fecal Incontinence Quality of life Scale.
  
  
  RESULTS
  Nineteen patients were included (ten patients SNS and nine PPTNS). SNS improved FI in nine of the ten patients. The mean Wexner score decreased significantly from a median of 14 (12-16) (preoperative) to 4 (1-8) (6-month revision) (p = 0.007). PTNS improved FI in seven of the nine patients. The mean Wexner score decreased significantly from a median of 12 (11-19) (preoperative) to 5 (4-7) (6-month revision) (p = 0.018). Both treatments produced symptomatic improvement without statistical differences between them.
  
  
  CONCLUSIONS
  Our study was nonrandomized with a relatively small number of patients. PPTNS had similar efficiency to the SNS in our men population. However, more studies are necessary to exclude selection bias and analyze long-term results.
authors.affiliation: Coloproctology Unit, Department of Surgery, University General Hospital of Elche, Alicante, Spain. pedromoyaforcen@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Moya
authors.affiliation: Coloproctology Unit, Department of Surgery, University General Hospital Reina Sofia, Murcia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Parra
authors.affiliation: Coloproctology Unit, Department of Surgery, University General Hospital of Elche, Alicante, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Arroyo
authors.affiliation: Coloproctology Unit, Department of Surgery, University General Hospital Reina Sofia, Murcia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Peña
authors.affiliation: Coloproctology Unit, Department of Surgery, University General Hospital Reina Sofia, Murcia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Benavides
authors.affiliation: Coloproctology Unit, Department of Surgery, University General Hospital of Elche, Alicante, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Calpena
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000294:innervation; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012447:Sacrum / Q000294:innervation; D013977:Tibia / Q000294:innervation; D013979:Tibial Nerve; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Fecal incontinence; Posterior tibial nerve stimulation; Sacral nerve modulation