EVALUATION OF POSTERIOR TIBIAL NERVE NEUROMODULATION AS A TREATMENT MODALITY FOR CHILDREN WITH IDIOPATHIC FECAL INCONTINENCE

Abstract

Idiopathic fecal incontinence IFI in children is a challenging problem. The pathology seems to be multifactorial. It’s diagnosed through accurate history taking, physical examination specially anorectal and neurological examination together with manometric pressure measurements. It could be treated by different lines as conservative (diet and HE), neuromodulation, biofeedback or surgery.Neuromodulation is considered as a new line of treatment which decrease the use of surgery and could be used when conservative measures fail. There are two types: sacral nerve stimulation (SNS) and Posterior tibial nerve stimulation (PTNS). PTNS is a non invasive, easy and cheap modality, it’s mechanism is still under research but it was believed that it modulates sacral nerve through posterior tibial nerve stimulation which in turn controls the rectum and anal canal.The aim of this study is to evaluate the outcome of PTNS as a treatment modality for idiopathic fecal incontinence in childrenSubject and methods