AB023. SOH22ABS138. Sacral and tibial nerve stimulation in the treatment of faecal incontinence post repair of anorectal malformation (ARM): a systematic review of the literature

Background: Anorectal malformation (ARM) refers to a congenital alteration in anatomy which is characterized by “abnormal or absent development of the anus and distal rectum” After correction, over 50% of patients suffer from faecal incontinence (FI) or constipation While sacral nerve stimulation (SNS) is a widely accepted treatment for FI, its use in those with ARM is not well studied. This study aims to collate the current research in the use of SNS or percutaneous tibial nerve stimulation (PTNS) in the treatment of FI in those with previously diagnosed ARM.

Methods: A review of the literature was carried out across three databases to include studies which reviewed the use of SNS or PTNS for the treatment of FI in a population in which at least a proportion had a previous diagnosis of ARM. The quality of the studies was assessed using the PRISMA checklist for systematic literature reviews, the SCARE guideline for case studies or the STROCSS checklist for cohort studies.

Results: A literature search yielded thirteen articles including five case reports, one review of the literature, two letters to the editor, two cohort studies, two pre and post design studies and one feasibility study. Quality assessment deemed most of the articles to be of poor quality. Statistical assessment could not be performed due to the heterogeneity of the data presented.

Conclusions: SNS and PTNS show promise for the treatment of FI in those post repair of ARM. Further studies are needed in this area, particularly to address the ARM and paediatric populations specifically.

Keywords: Anorectal malformation (ARM); faecal incontinence (FI); paediatric; sacral nerve stimulation (SNS); tibial nerve stimulation