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Background <p>Faecal incontinence (FI) increases up to 50% with age in institutionalized older individuals, and treatment options have been scarcely studied for older people. Posterior tibial nerve stimulation (PTNS) is a minimally invasive second-line treatment available. This research aims to assess long-term clinical outcomes of PTNS using the Wexner score in community-dwelling patients aged &gt; 65&#xa0;years, and its impact on quality of life (QoL).</p> Methods <p>A prospective cohort study with 61 patients (median age 71 years; 79% women) was conducted. PTNS was administered in three phases over 12&#xa0;months, with follow-ups (FUs) at 3, 6, 12 and 36&#xa0;months. Optimal responders (ORs) were defined as achieving a &gt; 50% reduction in Wexner score compared with baseline. Partial responders that presented a 25–50% reduction in Wexner score were also considered as potential long-term ORs.</p> Results <p>At the end of treatment, 64% of patients were OR, with sustained improvement in 77% of them at 36&#xa0;months. Wexner score significantly decreased throughout FUs, from median ten to four (<i>p</i> &lt; 0.001). Faecal incontinence quality of life questionnaires (FIQLs) showed limited improvement in depression domain at 6- and 36-month FUs. Faecal urgency improved in a logistic regression analysis (<i>p</i> &lt; 0.01). Multivariable logistic regression identified increasing age as independently associated with clinical response (<i>p</i> = 0.04).</p> Conclusions <p>PTNS was associated with improvement in incontinence severity scores and faecal urgency in selected community-dwelling older adults, although reductions in FI episode frequency and quality of life measures were limited. These findings suggest that PTNS may have a selective role within individualized management strategies, particularly in urgency-predominant symptoms.</p> Trial registration number <p>NCT05016453, retrospectively registered in 2021.</p>

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Posterior tibial neurostimulation for faecal incontinence in community-dwelling older adults: long-term outcomes and predictors of response

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月22日

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  • M. Bosch-Ramírez,
  • L. Sánchez-Guillén,
  • M. J. Alcaide,
  • M. Serrano-Navidad,
  • F. López-Rodríguez-Arias,
  • A. Sánchez-Romero,
  • A. Muñoz-Duyos,
  • A. Arroyo

摘要

Background

Faecal incontinence (FI) increases up to 50% with age in institutionalized older individuals, and treatment options have been scarcely studied for older people. Posterior tibial nerve stimulation (PTNS) is a minimally invasive second-line treatment available. This research aims to assess long-term clinical outcomes of PTNS using the Wexner score in community-dwelling patients aged > 65 years, and its impact on quality of life (QoL).

Methods

A prospective cohort study with 61 patients (median age 71 years; 79% women) was conducted. PTNS was administered in three phases over 12 months, with follow-ups (FUs) at 3, 6, 12 and 36 months. Optimal responders (ORs) were defined as achieving a > 50% reduction in Wexner score compared with baseline. Partial responders that presented a 25–50% reduction in Wexner score were also considered as potential long-term ORs.

Results

At the end of treatment, 64% of patients were OR, with sustained improvement in 77% of them at 36 months. Wexner score significantly decreased throughout FUs, from median ten to four (p < 0.001). Faecal incontinence quality of life questionnaires (FIQLs) showed limited improvement in depression domain at 6- and 36-month FUs. Faecal urgency improved in a logistic regression analysis (p < 0.01). Multivariable logistic regression identified increasing age as independently associated with clinical response (p = 0.04).

Conclusions

PTNS was associated with improvement in incontinence severity scores and faecal urgency in selected community-dwelling older adults, although reductions in FI episode frequency and quality of life measures were limited. These findings suggest that PTNS may have a selective role within individualized management strategies, particularly in urgency-predominant symptoms.

Trial registration number

NCT05016453, retrospectively registered in 2021.