Percutaneous Posterior Tibial Nerve Stimulation for MS-Associated Bowel Dysfunction

There are not a lot of available therapeutic options for patients with multiple sclerosis (MS) who suffer fecal incontinence (FI) and functional constipation (FC), which can have meaningful adverse effects on quality of life. A study evaluated the use of percutaneous posterior tibial nerve stimulation (PTNS) in FI and FC among patients with MS.

The study included patients with MS receiving 12 weeks of PTNS for neurogenic bladder; data collection included prevalence and severity of FI and FC. FI was defined per the Cleveland Clinic Fecal Incontinence Score (CCFIS), while FC was defined per the Rome III criteria. The Benefit Satisfaction and Willingness to Continue questionnaire was used to collect subjective data on treatment satisfaction.

Final analysis included 60 patients with FI and FC (n=25), FI without FC (n=5), and FC without FI (n=30). Median CCFIS before PTNS was 12.0 and decreased to 8.5 after treatment. Notable improvements were observed in liquid and flatal incontinence, need for pads, and lifestyle restrictions. Following PTNS, seven patients became FC free. None of the patients developed FC during the study. At the end of the study, more than half of the cohort was satisfied with the treatment and said they would be willing to continue PTNS.

“PTNS represents a valid minimally invasive alternative treatment for [patients with] MS suffering from [neurogenic bowel dysfunctions],” the researchers concluded.