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Percutaneous tibial nerve stimulation - PTNS: an alternative treatment option for chronic therapy resistant anal fissure

Aho Fält, Ursula LU ; Lindsten, Martin LU ; Strandberg, Sara ; Dahlberg, Mari ; Butt, Salma LU ; Nilsson, Emelie LU ; Zawadzki, Antoni LU and Johnson, Louis Banka LU (2019) In Techniques in Coloproctology 23(4). p.361-365
Abstract
Background

The aim of the present study was to evaluate percutaneous tibial nerve stimulation (PTNS) for treatment resistant chronic anal fissure.
Methods

Consecutive patients with chronic anal fissure were treated with neuromodulation via the posterior tibial nerve between October 2013 and January 2014. Patients had PTNS for 30 min on 10 consecutive days. All patients had failed conventional medical treatment. The visual analogue scale (VAS) score, St. Marks score, Wexner’s constipation score, Brief Pain Inventory (BPI-SF), bleeding and mucosal healing were evaluated before treatment, at termination, after 3 months, and then yearly for 3 years.
Results

Ten patients (4 males and 6 females; mean age 49.8... (More)
Background

The aim of the present study was to evaluate percutaneous tibial nerve stimulation (PTNS) for treatment resistant chronic anal fissure.
Methods

Consecutive patients with chronic anal fissure were treated with neuromodulation via the posterior tibial nerve between October 2013 and January 2014. Patients had PTNS for 30 min on 10 consecutive days. All patients had failed conventional medical treatment. The visual analogue scale (VAS) score, St. Marks score, Wexner’s constipation score, Brief Pain Inventory (BPI-SF), bleeding and mucosal healing were evaluated before treatment, at termination, after 3 months, and then yearly for 3 years.
Results

Ten patients (4 males and 6 females; mean age 49.8 years) were identified but only 9 were evaluated as one patient’s fissure healed before PTNS was started. At 3-year follow-up, fissures had remained completely healed in 5 out of 9 patients. All patients stopped bleeding and were almost completely pain-free at 3 years (VAS p = 0.010) and pain relief improved from 50% at completion to 90% at 3 years. The patients’ Wexner constipation scores improved significantly (p = 0.007).
Conclusions

In this small series, PTNS enhanced healing of chronic anal fissure and reduced pain and bleeding with an associated improvement in bowel function. (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Techniques in Coloproctology
volume
23
issue
4
pages
361 - 365
publisher
Springer
external identifiers
  • scopus:85066232261
  • pmid:30972649
ISSN
1123-6337
DOI
10.1007/s10151-019-01972-5
language
English
LU publication?
yes
id
62c12cec-3e1d-49ea-84a0-42e4d56adfa9
date added to LUP
2019-03-23 17:59:58
date last changed
2020-10-07 06:22:28
@article{62c12cec-3e1d-49ea-84a0-42e4d56adfa9,
  abstract     = {Background<br/><br/>The aim of the present study was to evaluate percutaneous tibial nerve stimulation (PTNS) for treatment resistant chronic anal fissure.<br/>Methods<br/><br/>Consecutive patients with chronic anal fissure were treated with neuromodulation via the posterior tibial nerve between October 2013 and January 2014. Patients had PTNS for 30 min on 10 consecutive days. All patients had failed conventional medical treatment. The visual analogue scale (VAS) score, St. Marks score, Wexner’s constipation score, Brief Pain Inventory (BPI-SF), bleeding and mucosal healing were evaluated before treatment, at termination, after 3 months, and then yearly for 3 years.<br/>Results<br/><br/>Ten patients (4 males and 6 females; mean age 49.8 years) were identified but only 9 were evaluated as one patient’s fissure healed before PTNS was started. At 3-year follow-up, fissures had remained completely healed in 5 out of 9 patients. All patients stopped bleeding and were almost completely pain-free at 3 years (VAS p = 0.010) and pain relief improved from 50% at completion to 90% at 3 years. The patients’ Wexner constipation scores improved significantly (p = 0.007).<br/>Conclusions<br/><br/>In this small series, PTNS enhanced healing of chronic anal fissure and reduced pain and bleeding with an associated improvement in bowel function.},
  author       = {Aho Fält, Ursula and Lindsten, Martin and Strandberg, Sara and Dahlberg, Mari and Butt, Salma and Nilsson, Emelie and Zawadzki, Antoni and Johnson, Louis Banka},
  issn         = {1123-6337},
  language     = {eng},
  number       = {4},
  pages        = {361--365},
  publisher    = {Springer},
  series       = {Techniques in Coloproctology},
  title        = {Percutaneous tibial nerve stimulation - PTNS: an alternative treatment option for chronic therapy resistant anal fissure},
  url          = {http://dx.doi.org/10.1007/s10151-019-01972-5},
  doi          = {10.1007/s10151-019-01972-5},
  volume       = {23},
  year         = {2019},
}