Bilateral posterior tibial nerve stimulation as a neuromodulation strategy for obstructed defecation: a randomized controlled trial

Obstructed defecation syndrome (ODS) is a prevalent pelvic floor disorder, often impairing patients’ quality of life. Noninvasive therapies, including posterior tibial nerve stimulation (PTNS), have been explored as alternative treatments. This study evaluates the efficacy of bilateral transcutaneous posterior tibial nerve stimulation (BT-PTNS) compared to medical treatment alone in patients with ODS without anatomical abnormalities.

Group A exhibited a significant reduction in MODS scores (mean decrease = 10 points) compared to group B (mean decrease = 4 points) after 6 weeks (p < 0.001). PAC-QOL scores improved significantly in group A (65% reduction) compared to group B (37% reduction). Electromyographic analysis in group A showed significant improvement in amplitude, number of motor unit turns, and duration (p < 0.001). No adverse events were reported in either group.

BT-PTNS is a safe and effective noninvasive treatment for ODS without anatomical abnormalities, significantly improving symptom severity and quality of life. Further multicentric trials are warranted to standardize treatment protocols and assess long-term outcomes.