PERCUTANEOUS TIBIAL NERVE STIMULATION FOR TREATMENT OF ANAL INCONTINENCE

Faecal incontinence (FI) is a not common symptom in the general population (0.4–2.2% in population-based studies), which 342 Tech Coloproctol (2009) 13:341–368 123 affects predominantly the elderly people, with a female prevalence. FI has a notable public health impact. It is psychologically and physically debilitating and can lead the patient to isolation and progressive loss of all social activities. Patient selection is decisive to opt for an effective intervention. A conservative approach is required to treat mild to moderate FI; it is based on nutritional, medical and rehabilitative therapy, with a success rate of5%. In no-responsive cases, other several different semi-conservative procedures, such as bulking agents, injection or sacral neuromodulator implant can be proposed prior to resorting to surgery. One of the least invasive forms of neuromodulation is the tibial nerve percutaneous stimulation (PTNS), currently used for a wide variety of urologic conditions.PTNS seems to be a safe and effective therapeutic option and it could represent a valid approach to mild to moderate FI. Tolerableness, affordability and mininvasivity of this simple procedure compel to further studies