Transanal electrostimulation in the treatment of fecal incontinence following low anterior rectum resection

Basal and squeeze anal pressure (BAP and SAP respectively) are reduced and fecal incontinence (FI) is common due to the partial denervation of the anal sphincter (AS). Transanal electrostimulation (TES) has been shown to improve sphincter function in partially denervated muscle. The aim was to determine AS function following TES. 20 patients (m/f-14/6) with partial FI 6 months after LAR underwent intermittent TES (50 Hz, 5 sec. intervals, 15 min, b.i.d.) for 3 months with use of TNS SM1i electrostimulation device and endoanal electrodes 12C (Schwa-medico, Germany). Anorectal manomentry was studied before and after TES. FI was evaluated according to the Incontinence Scoring System (ISS) before and after the treatment. Targeted application of TES increased BAP and SAP in 60 % of patients. The mean rise in BAP reached 18 mmHg and 30 mmHg in SAP. Continence significantly improved in 80 % of pts. ISS and Holschneider scale scores improved significantly as well as patients' life style. TES of the AS muscles following LAR can increases BAP and SAP and improves FI in patients after LAR. value and long-term effectiveness of this method requires further evaluation.