Effects of Tibial Nerve Electrostimulation in Patients With Fecal Incontinence: A Systematic Review

TL;DR

This paper reviews how tibial nerve electrostimulation can help reduce fecal incontinence episodes and improve quality of life in patients.

Contribution

The study systematically evaluates the efficacy and safety of posterior tibial nerve stimulation for fecal incontinence using PRISMA and Cochrane guidelines.

Findings

Most studies showed a 50% or more reduction in fecal incontinence episodes.

PTNS improved severity scores and quality of life with a favorable safety profile.

Abstract

Fecal incontinence (FI) is a condition characterized by the involuntary loss of stool, resulting from the inability to control the sphincter and neuromuscular mechanisms responsible for continence. Percutaneous electrical stimulation of the posterior tibial nerve (posterior tibial nerve stimulation—PTNS) has been used as a therapeutic alternative in the treatment of FI. The objective of this study was to investigate the efficacy.

A systematic review was conducted according to the recommendations and criteria described in the PRISMA (Preferred Reporting Guide to Systematic Reviews and Meta‐Analyses) items and in the Cochrane Manual. Experimental studies that evaluated the effects of posterior tibial nerve electrostimulation in adult patients with fecal incontinence were included. Case reports, literature reviews, and gray literature were excluded. The search was performed in the MEDLINE/PubMed, Cochrane Library, Scopus, Regional Portal of the VHL, Embase, CINAHL, and Web of Science databases.

Seventeen studies were included, totaling 1248 participants. The average duration of treatment protocols was 12 weeks, with predominantly weekly interventions. The most frequently used stimulation parameters included frequencies between 10 and 20 Hz and pulse widths of 200 μs.

Most studies demonstrated a reduction of 50% or more in fecal incontinence episodes, as well as significant improvement in severity scores and quality of life. Randomized clinical trials presented a low risk of bias, while some observational studies demonstrated methodological limitations. PTNS is a minimally invasive intervention with a favorable safety profile and potential clinical applicability.

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