<p>Is posterior tibial nerve stimulation an effective treatment for faecal incontinence? J Nicholson, J Pearson, C Molyneux, A Sharma, K Telford, E Kiff University Hospital South Manchester</p><p>Introduction: Posterior tibial nerve stimulation (PTNS) is a new neuromodulation treatment for faecal incontinence (FI). Our aim of this study was to establish if PTNS is effective, and for which subgroups of FI and whether it influences manometry variables.</p><p>Method: Prospective observational cohort study in a tertiary pelvic floor unit. Patients received PTNS for 30mins once a week for 12 weeks. High resolution anal manometry (HRAM), 2-week bowel diary, FI severity score (Vaizey), FI specific QOL questionnaire (MHQ) were recorded before and 2-weeks after treatment. Clinical data and subjective patient reported outcome (success/fail) were recorded.</p><p>Results: 23 patients, 19 (83%) women, median age 62 (31-78). 12 (52%) mixed incontinence, 7 (30%) urge incontinence, 4 (18%) passive incontinence. We found a reduction in mean urgency episodes (19v11, p=0.002), urge FI episodes (6v2, p=0.038) and passive FI episodes (12v8, p=0.154), with improved Vaizey (16.7v14.4, p=0.003) and MHQ (481.9v413.1 p=0.039) scores.</p><p>All HRAM variables (mmHg) increased; MRP (40v46, p=0.088), MSP (72v92, p=0.009) and ISP (32v45, p=0.031). Increased rectal sensation (mls); onset (42v33, p=0.064), call (80v54, p=0.000) and urge (112v82, p=0.001).</p><p>Subjective success occurred in 74% (17), 4 of 6 that failed had passive incontinence. Objective success (defined as >50% or >70% improvement in 2 or more of the following; overall FI episodes, urgency episodes, urge FI episodes, passive FI episodes, Vaizey and MHQ scores) was seen in 52% (12) and 39% (9) respectively. 3 of the 4 men did not improve subjectively or objectively.</p><p>Discussion: PTNS subjectively helped 17 of 23 patients, reflected in improved questionnaires and fewer incontinence episodes. They had increased rectal awareness and stronger squeeze pressures which may have given them more warning and the ability to defer defecation. This study suggests that PTNS seems to help women with urge incontinence.</p>