Percutaneous Tibial Nerve Stimulation (PTNS) – Innovation in the Treatment of Faecal

IncontinenceJanice Reid

Continence Services ManagerWestern Health & Social Care Trust

Linen Suite, Mossley Mill9th October 2013

9th October 2013Linen Suite, Mossley Mill

Vision without action is dreaming…Action without vision is just passing the time of day….BUT, combine vision with action and you change the world!

Nelson Mandela

9th October 2013Linen Suite, Mossley Mill

Aim of Presentation

PTNS, the Continence Nurse Specialist and the Patient….

the journey to success together

ROAD TO SUCCESS

9th October 2013Linen Suite, Mossley Mill

Lets start with the problem...

6.5 million people in UK today with some kind of bowel problem

9th October 2013Linen Suite, Mossley Mill

Impact of Faecal Incontinence

• 20 – 30 referrals per year• Limited treatment options• Incontinence still taboo• Social stigma

9th October 2013Linen Suite, Mossley Mill

Let me introduce PTNS…

• 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

9th October 2013Linen Suite, Mossley Mill

PTNS TREATMENT

9th October 2013Linen Suite, Mossley Mill

Getting started• Funding• Training• Competency framework• Care pathway• Evaluation strategy

9th October 2013Linen Suite, Mossley Mill

Challenges

• New to NI – training issues?• New treatment - no long term data

9th October 2013Linen Suite, Mossley Mill

Enablers• 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

9th October 2013Linen Suite, Mossley Mill

Case history 1• 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

9th October 2013Linen Suite, Mossley Mill

Case history 2• 38 yr old para 1 • Faecal urgency/incontinence/flatus• Weak anal tone • After treatment – 40% reduction in

incontinent episodes / flatus now controlled

9th October 2013Linen Suite, Mossley Mill

From the patient…..My life is transformed

– thank you

I was practically housebound before

– I feel I have my life back

9th October 2013Linen Suite, Mossley Mill

From the patient…..

For the first time in years I had the confidence to go out

for a family meal

9th October 2013Linen Suite, Mossley Mill

In summary…• PTNS – safe, well tolerated, minimally

invasive procedure• Significant reduction in Faecal

Incontinence episodes• Less medication, less pads• Impact on Quality of Life

9th October 2013Linen Suite, Mossley Mill

Key messageIf there is anyone out there who stillDOUBTS their own abilitiesWONDERS if it is worth making the effort in these difficult timesQUESTIONS the power and passion of committed nurses

THEN

9th October 2013Linen Suite, Mossley Mill

Just Remember…..Vision without action is dreaming…Action without vision is just passing the time of day….BUT, combine vision with action and you change the world!

Nelson Mandela