Transcript Percutaneous Tibial Nerve Stimulation (PTNS) * Innovation

Janice Reid
Continence Services Manager
Western Health & Social Care Trust
LSA Midwifery Conference
Mossley Mill
29/01/2014
PTNS, the Continence Nurse
Specialist and the Patient….
the journey to success
together
ROAD TO
SUCCESS
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6.5 million people in
UK today with some
kind of bowel problem
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Involuntary leakage of
 Solid matter
 Liquid
 Gas (anal incontinence)
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 Damage
to the rectum or anus
 Bowel motility problems
 Stool consistency problems
 Neurological damage e.g.
motor/sensory, MS, Diabetes,
post hysterectomy
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 20
– 30 referrals per year
 Limited treatment options
 Incontinence still taboo
 Social stigma
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A
first for Northern Ireland
 Urgent PC neuromodulation
system - uses established
technique of electrical
stimulation
 Can be implemented by
specialist nurses in a clinic
setting
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


78.2% improvement in patients with FI treated
with PTNS on alternate days for 4 weeks
(Shafik et al 2003)
17 patients with FI treated with PTNS for 6
weeks – significant improvement in
continence scores (Govaert et al 2008)
100 patients – urge, passive and mixed FI.
Statistically significant improvement in mixed
& urge (Hotouras et al 2011)
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 Funding
 Training
 Competency
framework
 Care pathway
 Evaluation strategy
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 New
to NI – training issues?
 New treatment - no long term
data
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 The
ethos of Transforming
Your Care
 A focused and motivated team
of specialist nurses with a
desire to improve the lives of
patients with Faecal
Incontinence
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 58
yr old nulliparous lady –
mixed urge and passive FI
 Very weak anal tone / Pelvic
floor contraction
 After treatment - incidence of
FI reduced by 50%
 Significant improvement in
QoL
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 38
yr old para 1
 Faecal
urgency/incontinence/flatus
 Weak anal tone
 After treatment – 40% reduction
in incontinent episodes / flatus
now controlled
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My life is
transformed
– thank you
I was practically
housebound before
– I feel I have my life back
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For the first time in years I
had the confidence to go
out for a family meal
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 PTNS
– safe, well tolerated,
minimally invasive procedure
 Significant reduction in Faecal
Incontinence episodes
 Less medication, less pads
 Impact on Quality of Life
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
Ask questions!!!

Keep in mind that FI is a symptom – often
with multiple contributory factors

Keep the patient as the focus

Never be afraid to act on your vision
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