Comparison of Percutaneous Tibial Nerve Stimulation and Injection of Bulking Agent Methods in the Treatment of Fecal Incontinence

Abstract

Aim: Fecal incontinence is still a complex disorder in the daily practices of colorectal surgeons. Nerve stimulation and injection of bulking agent aretwo minimal invasive methods in the treatment of fetal incontinence. In the present study, the aim was to compare the short-term effectiveness ofpercutaneous tibial nerve stimulation (PTNS) and injection of bulking agent in the treatment of fecal incontinence.Method: A total of 41 patients with fecal incontinence, who were treated with PTNS or bulking agent injection at İstanbul University İstanbul Facultyof Medicine, were enrolled in the study. Both groups were evaluated in terms of demographic data, the etiology of fecal incontinence, anorectalphysiology test results, Wexner Fecal Incontinence Score and Modified Fecal Incontinence Quality of Life-Scale scores. The questionnaires wereperformed in the 12th month of the pre- and post-treatment periods.Results: Of the patients, 24 (59%) were female, and 17 (41%) were male. The median age was 50 years (in between 25-71 years), and the mean bodymass index was 27.7 kg/m2 (in between 20-41 kg/m2). Twenty-two (54%) patients underwent PTNS; whereas, 19 (46%) patients underwent bulkingagent injection. Both groups were found to be similar in terms of demographic data, pre-treatment fecal incontinence assessment and quality of lifemeasurement. When the pre- and post-treatment fecal incontinence and the quality of life scores of the patients were evaluated, both methods werefound to be efficient in the treatment of fecal incontinence (p<0.001). It has been experienced that these two techniques were equally effective whenthey were compared to each other (p=0.315 and 0.501).Conclusion: Both techniques were effective in the treatment of fecal incontinence. The percutaneous tibial nerve stimulation is less invasive, whereasinjection of bulking agent provides fewer hospital visits with faster improvement.Keywords: Fecal incontinence, nerve stimulation, injection of bulking-agent