الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Idiopathic fecal incontinence IFI in children is a devastating, challenging problem which could be missed as most of studies couldn’t differentiate between it and constipation related FI. The pathology seems to be multifactorial. It’s diagnosed through accurate history taking, physical examination specially anorectal and neurological examination together with manometric pressure measurements. It could be treated by different lines as conservative diet and HE, NM and BF or surgery.
Neuromodulation is considered as a new line of treatment which decrease the use of surgery and could be used when conservative measures fail. There are two types: SNS and PTNS.
Posterior tibial nerve stimulation (PTNS) is a non invasive, easy and cheap modality, it’s mechanism is still under research but it was believed that it modulates sacral nerve through posterior tibial nerve stimulation which in turn controls the rectum and anal canal.
The present study included 30 children from 4 to 12 years old who had mild to moderate IFI, they were evaluated by Wexner scale, digital anal testing of PFMs according to MOS and manometric measurements of PFMs before and after the treatment program which consists of HE, diet and TPTNS bilaterally 30 minutes twice weekly for up to 3 months.
Children mean age was years (ranged from 4.5 to 12 years), 19 males and 11 females. Fecal incontinence age of onset was 5.96 ±1.91 years (ranged from 4.0 to 10.0 years). Four children had incontinence twice a week, 10 children once weekly, 7 children twice daily and 9 children once daily. Mean duration of complaint in all children was 3.15 ± 2.24 years (ranged from 0.50 to 7.0 years).
Two children were dropped out during the follow up due to loss of contact. Two cases showed no improvement, 12 cases were improved partially and 14 were completely improved. There were statistically significant differences as regards MOS grading which has increased 3.39