The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Percutaneous tibial nerve stimulation (PTNS) for faecal incontinence.
Faecal incontinence occurs when a person loses (often only partially) voluntary control of their bowel movements, resulting in leakage of faeces. The condition may relate to inadequate formation of the anus from birth. It can also relate to diseases of the nervous system (such as spina bifida, spinal cord injury, multiple sclerosis), pelvic organ prolapse, or previous pelvic surgery or radiotherapy. In women, another cause is injury to the anal canal during childbirth. This procedure involves inserting a fine needle into a nerve just above the ankle and passing a mild electric current through the needle to the nerves that control bowel function
A70.4 Insertion of neurostimulator electrodes into peripheral nerve
Z12.2 Posterior tibial nerve
In addition ICD-10 code R15.X Faecal incontinence is assigned.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.