Sacral transcutaneous electrical nerve stimulation in the treatment of idiopathic faecal incontinence

Abstract

The aim of this study was to investigate the potential use of S3 transcutaneous electrical nerve stimulation (TENS) in the treatment of idiopathic faecal incontinence. Seventeen patients were treated by S3 TENS 2 h a day for 3 months. The outcome was evaluated by faecal incontinence severity index (FISI), faecal incontinence quality of life scale (FIQOL), 7-day bowel diary, anorectal physiology, patients' self-reported impression of improvement, bowel control and satisfaction with treatment on a visual analogue scale. Seventeen patients (13 women) of mean age 67.2 years (52-80) were followed up for a mean of 19.7 months. The FISI improved in 69% after 3 months of TENS (P < 0.01), and all components of FIQOL improved. The number of incontinent episodes per week fell for incontinence to gas and stool (solid and/or liquid). There was no significant difference in the maximum resting pressure and squeeze pressure, but the mean rectal volume of first sensation (12.1 ml, P = 0.027) and first urge (25.0 ml, P = 0.054) fell, and the maximum tolerable volume (16.0 ml, P = 0.679) rose. The satisfaction score was ≥ 6/10 in all patients. Fifteen (88%) scored ≥ 6/10 for bowel control, and all patients scored ≥ 2 (scale: -5 to +5) for their impression of improvement. S3 transcutaneous electrical nerve stimulation seems to be a promising noninvasive method to treat faecal incontinence. However, further study is required.