A Randomized Controlled Trial Comparing the Efficacy of Bilateral Percutaneous Tibial Nerve Stimulation Versus Biofeedback Pelvic Floor Muscle Training in the Management of Obstructed Defecation Syndrome

Introduction Obstructed defecation syndrome (ODS) is a common disorder in developed countries. This study aims to compare the efficacy of bilateral percutaneous tibial nerve stimulation (Bi-PTNS) to biofeedback therapy (BFT) in adult patients with ODS. Methods A prospective randomised control study was conducted on patients aged ≥18 years, diagnosed with ODS, who were referred to the Colorectal Surgery Department at a main university hospital between 2018 and 2020. Computerized 1:1 block randomization allocated patients into two groups: the bi-PTNS group and the BFT group. The Constipation Scoring System and Patient Assessment of Constipation Quality of Life Score (PAC-QoL) were used to assess the severity of the patient's symptoms prior to and after treatment. The primary outcome was the improvement of the Constipation Scoring System. The secondary outcome was the PAC-QoL score. Results In total, 60 patients, with 38 females (mean of 43 years in the BFT group and 48 years in the Bi-PTNS group), were studied. Statistically significant differences were achieved in patients who underwent bi-PTNS compared to the BFT group (p < 0.001). The average improvement in the Constipation Scoring System score for the bi-PTNS group was 66.66% ± 8.44 compared to 47.36% ± 10.44 for the BFT group. The bi-PTNS group showed improvement in the PAC-QoL score (60.41% ± 4.03) compared with 42.59% ±6.25 in the BFT group. Conclusion The Bi-PTNS intervention was more effective than BFT in alleviating symptoms of OD compared to BFT, evidenced by improvements in both the Constipation Scoring System and PAC-QoL scores.