Short-term outcome of percutaneous tibial nerve stimulation for low anterior resection syndrome: results of a pilot study

Percutaneous tibial nerve stimulation (PTNS) is a minimally invasive procedure, which has been demonstrated to be effective in faecal/urinary incontinence, but has never been tested in Low Anterior Resection Syndrome (LARS). The severity of LARS may be evaluated by the LARS-score, but rectal cancer treatments may also affect urinary and sexual function, which are not explored by the LARS-score. The TAPE-score is a new validated index addressing the overall pelvic-floor functions. This study aims to assess the efficacy of PTNS in LARS patients and to evaluate the results by the LARS and TAPE scores.

21 patients operated on for rectal cancer between 2009 and 2014 complaining of LARS underwent PTNS (12 sessions of 30' each). Six patients reported urinary incontinence and all except two (males) were sexually inactive. The LARS-score and the TAPE-score questionnaires were administered at baseline, and after six months follow up.

At 6 months follow-up, 9 patients reported a significant improvement of faecal incontinence, and 3/6 an improvement of urinary incontinence after PTNS. Median LARS-score significantly decreased from 32 to 27 (p=0.009), while the median TAPE-score improved significantly from 55 to 58, (p=0.004).

PTNS may be a further option in the treatment of selected patients with LARS and in addition may improve associated urinary incontinence. The severity of LARS can be detected by the LARS scores, however, the adoption of the TAPE-score should be preferred in case of concomitant urinary and/or sexual problems not explored by the LARS score. This article is protected by copyright. All rights reserved.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 2017 Mar 29 [Epub ahead of print]

D F Altomare, A Picciariello, C Ferrara, R Digennaro, Y Ribas, M De Fazio

Dept of Emergency and Organ Transplantation and Inter-Department Research Center for Pelvic Floor, Diseases (CIRPAP) University "Aldo Moro" of Bari, Bari, Italy., Department of Surgery, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.