{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:15:14Z","timestamp":1785453314381,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Fecal incontinence is a condition that carries high social stigmatization and a determining factor in the quality of life of the person who suffers from it. Its etiology is multifactorial and treatment includes surgical and conservative measures, including stimulation of the posterior tibial nerve. The aim of this review is to determine whether posterior tibial nerve stimulation (PTNS) is more effective than other treatments in reducing episodes of fecal incontinence in adults. A systematic review of randomized clinical trials that analyzed different approaches and comparisons with other treatments in adults without neurological or metabolic diseases was carried out, analyzing, fundamentally, the reduction of episodes of fecal incontinence. In general, a reduction in fecal incontinence episodes is observed in the experimental groups compared with the control groups, although these differences are not significant in most studies. The results regarding the effectiveness of PTNS in reducing episodes of fecal incontinence compared to other treatments are not entirely conclusive, although benefits are observed regarding the stimulation of sacral roots. More well-designed studies with a long-term follow-up of the results are needed so that the recommendation of this treatment can be generalized.<\/jats:p>","DOI":"10.3390\/jcm11175191","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T21:27:17Z","timestamp":1662067637000},"page":"5191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9103-9696","authenticated-orcid":false,"given":"Alfonso Javier","family":"Ib\u00e1\u00f1ez-Vera","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Campus las Lagunillas, University of Jaen, 23071 Jaen, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Mar\u00eda","family":"Mond\u00e9jar-Ros","sequence":"additional","affiliation":[{"name":"Physiotherapy Mondave, Avenida Juan Carlos I, 38, 30800 Lorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-9343","authenticated-orcid":false,"given":"Vanessa","family":"Franco-Bernal","sequence":"additional","affiliation":[{"name":"Physiotherapy of Pelvic Floor, Campus Teatinos, University of Malaga, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2261-5482","authenticated-orcid":false,"given":"Guadalupe","family":"Molina-Torres","sequence":"additional","affiliation":[{"name":"Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, 04120 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Diaz-Mohedo","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, Campus Teatinos, University of Malaga, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"ref_1","unstructured":"Asociaci\u00f3n Espa\u00f1ola de Coloproctolog\u00eda (2022, February 20). Incontinencia Fecal. Available online: https:\/\/www.aecp-es.org\/images\/site\/pacientes\/Dic2019\/Incontinencia_fecal.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"577","DOI":"10.17235\/reed.2018.5007\/2017","article-title":"Posterior tibial nerve stimulation in the treatment of fecal incontinence: A systematic review","volume":"110","year":"2018","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_3","unstructured":"Shah, R., and Villanueva Herrero, J.A. (2022). Fecal Incontinence. StatPearls, StatPearls Publishing."},{"key":"ref_4","unstructured":"Sociedad Andaluza de Patolog\u00eda Digestiva (2022, June 11). RAPD Online |SAPD|. Available online: https:\/\/www.sapd.es\/revista\/2022\/45\/3."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.jamda.2019.03.033","article-title":"The Prevalence, Incidence, and Correlates of Fecal Incontinence Among Older People Residing in Care Homes: A Systematic Review","volume":"20","author":"Musa","year":"2019","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3748\/wjg.v23.i1.11","article-title":"Fecal incontinence\u2014Challenges and solutions","volume":"23","author":"Kaiser","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1053\/j.gastro.2003.10.010","article-title":"Epidemiology of fecal incontinence","volume":"126","author":"Nelson","year":"2004","journal-title":"Gastroenterology"},{"key":"ref_8","first-page":"1","article-title":"Double-blind randomised controlled trial of percutaneous tibial nerve stimulation versus sham electrical stimulation in the treatment of faecal incontinence: CONtrol of Faecal Incontinence using Distal NeuromodulaTion (the CONFIDeNT trial)","volume":"19","author":"Horrocks","year":"2015","journal-title":"Health Technol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1007\/s00384-020-03803-8","article-title":"Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: A systematic literature review","volume":"36","author":"Desprez","year":"2021","journal-title":"Int. J. Colorectal. Dis."},{"key":"ref_10","unstructured":"Maestre Gonz\u00e1lez, Y. (2013). Prevalencia de la Incontinencia Fecal en un Sector de la Ciudad de Barcelona y An\u00e1lisis de su Impacto en la Calidad de vida y la Salud Mental. [Ph.D. Thesis, Universitat Aut\u00f2noma de Barcelona]."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"419","DOI":"10.32598\/bcn.9.10.290","article-title":"Posterior Tibial Nerve Stimulation in Fecal Incontinence: A Systematic Review and Meta-Analysis","volume":"10","author":"Sarveazad","year":"2019","journal-title":"Basic Clin. Neurosci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/codi.15390","article-title":"The science behind programming algorithms for sacral neuromodulation","volume":"23","author":"Knowles","year":"2021","journal-title":"Colorectal. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9139","DOI":"10.3748\/wjg.v19.i48.9139","article-title":"Posterior tibial nerve stimulation for fecal incontinence: Where are we?","volume":"19","author":"George","year":"2013","journal-title":"WJG"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1038\/ajg.2012.330","article-title":"Transcutaneous electrical tibial nerve stimulation in the treatment of fecal incontinence: A randomized trial (CONSORT 1a)","volume":"107","author":"Leroi","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.recesp.2021.06.016","article-title":"Declaraci\u00f3n PRISMA 2020: Una gu\u00eda actualizada para la publicaci\u00f3n de revisiones sistem\u00e1ticas","volume":"74","author":"Page","year":"2021","journal-title":"Rev. Espa\u00f1ola Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/nmo.12256","article-title":"Effects of transcutaneous tibial nerve stimulation on anorectal physiology in fecal incontinence: A double-blind placebo-controlled cross-over evaluation","volume":"26","author":"Bouguen","year":"2014","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1002\/bjs.9695","article-title":"Randomized clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence","volume":"102","author":"Thin","year":"2015","journal-title":"Br. J. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/DCR.0000000000001913","article-title":"Randomized Pilot Study: Anal Inserts Versus Percutaneous Tibial Nerve Stimulation in Patients with Fecal Incontinence","volume":"64","author":"Leo","year":"2021","journal-title":"Dis. Colon. Rectum."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1097\/DCR.0000000000001614","article-title":"Randomized Pilot Trial of Percutaneous Posterior Tibial Nerve Stimulation Versus Medical Therapy for the Treatment of Low Anterior Resection Syndrome: One-Year Follow-up","volume":"63","author":"Cuicchi","year":"2020","journal-title":"Dis. Colon. Rectum."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1097\/DCR.0000000000000444","article-title":"Short-term Outcomes of a Randomized Pilot Trial of 2 Treatment Regimens of Transcutaneous Tibial Nerve Stimulation for Fecal Incontinence","volume":"58","author":"Rimmer","year":"2015","journal-title":"Dis. Colon. Rectum."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1002\/bjs.10590","article-title":"Randomized clinical trial of percutaneous tibial nerve stimulation versus sham electrical stimulation in patients with faecal incontinence","volume":"104","author":"Giuliani","year":"2017","journal-title":"Br. J. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.jamda.2012.10.021","article-title":"A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care","volume":"14","author":"Booth","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1002\/bjs.9000","article-title":"Randomized controlled trial of percutaneous versus transcutaneous posterior tibial nerve stimulation in faecal incontinence","volume":"100","author":"George","year":"2013","journal-title":"Br. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1016\/S0140-6736(15)60314-2","article-title":"Percutaneous tibial nerve stimulation versus sham electrical stimulation for the treatment of faecal incontinence in adults (CONFIDeNT): A double-blind, multicentre, pragmatic, parallel-group, randomised controlled trial","volume":"386","author":"Knowles","year":"2015","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1111\/codi.12428","article-title":"A pilot study to compare daily with twice weekly transcutaneous posterior tibial nerve stimulation for faecal incontinence","volume":"15","author":"Thomas","year":"2013","journal-title":"Colorectal. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1093\/bjs\/znaa171","article-title":"Percutaneous tibial nerve stimulation in patients with severe low anterior resection syndrome: Randomized clinical trial","volume":"108","author":"Marinello","year":"2021","journal-title":"Br. J. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"654","DOI":"10.14309\/ajg.0000000000001605","article-title":"Percutaneous Tibial Nerve Stimulation vs. Sham Stimulation for Fecal Incontinence in Women: NeurOmodulaTion for Accidental Bowel Leakage Randomized Clinical Trial","volume":"117","author":"Zyczynki","year":"2022","journal-title":"Am. J. Gastroenterol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/BF02237236","article-title":"Fecal incontinence quality of life scale: Quality of life instrument for patients with fecal incontinence","volume":"43","author":"Rockwood","year":"2000","journal-title":"Dis. Colon Rectum."},{"key":"ref_29","unstructured":"Niveles de Evidencia y Grados de Recomendaci\u00f3n (2022, June 14). Gu\u00edaSalud. Available online: https:\/\/portal.guiasalud.es\/egpc\/lupus-niveles\/."},{"key":"ref_30","unstructured":"Centre for Evidence-Based Medicine (2009). Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009), University of Oxford."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:22:02Z","timestamp":1760142122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,1]]},"references-count":30,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11175191"],"URL":"https:\/\/doi.org\/10.3390\/jcm11175191","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,1]]}}}