Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and IrelandApr 4, 2017

Short-term results of nerve stimulation treatment for bowel problems after rectal surgery

Gut-Brain Axis Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 5, 2026

Abstract

At 6 months, the median LARS score decreased from 32 to 27, indicating improvement in low anterior resection syndrome symptoms.

Nine patients reported significant improvement in faecal incontinence after undergoing percutaneous tibial nerve stimulation (PTNS).
Three out of six patients with urinary incontinence experienced improvement following PTNS treatment.
The median TAPE score increased from 55 to 58, suggesting enhanced overall pelvic floor function.
PTNS may offer a treatment option for selected patients with low anterior resection syndrome and associated urinary incontinence.
The LARS score effectively measures LARS severity, but the TAPE score is preferable for assessing additional urinary and sexual function issues.

Simplified

AIM: 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 Three Axial Perineal Evaluation (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.

METHODS: Twenty-one patients operated on for rectal cancer between 2009 and 2014 complaining of LARS underwent PTNS (12 sessions of 30 min each). Six patients reported urinary incontinence and all except two (men) were sexually inactive. The LARS score and the TAPE score questionnaires were administered at baseline and after 6 months of follow-up.

RESULTS: At 6 months' follow-up, nine 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).

CONCLUSIONS: 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 score; however, the adoption of the TAPE score is preferred in the case of concomitant urinary and/or sexual problems not explored by the LARS score.

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Short-term results of nerve stimulation treatment for bowel problems after rectal surgery

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