TOPLINE:

Translumbosacral neuromodulation therapy (TNT) significantly improved lumbosacral neuropathy and reduced fecal incontinence episodes compared with sham treatment in affected patients.

METHODOLOGY:

• Fecal incontinence is a multifactorial condition often driven by underrecognized neuropathic dysfunction.
• Researchers conducted a randomized, sham-controlled trial involved 109 patients (mean age, 64.3 years; 79% women) who experienced more than one fecal incontinence episode per week.
• Participants received either TNT (2400 or 3600 magnetic stimulations; n = 38 and n = 37, respectively) or a sham treatment (n = 34) at lumbar and sacral sites, administered at 1 Hz once a week for 6 weeks.
• Lumbosacral motor evoked potentials (MEPs) were assessed using a translumbosacral anorectal magnetic stimulation test at baseline and after 6 weeks.
• The primary outcome was the change in MEP latency. Secondary outcomes included change in the number of fecal incontinence episodes, responder rates, anorectal physiology, and device tolerability. 

TAKEAWAY:

• TNT led to significant reductions in MEP latencies in the 3600-stimulation group and in the 2400-stimulation group compared with those in the sham group (P ≤ .05).
• The mean number of fecal incontinence episodes decreased in the TNT groups, which also had higher responder rates than the sham group (P < .001 for both).
• TNT was associated with significant improvements in maximal and sustained anal squeeze pressure (P < .05).
• The therapy was well tolerated by patients.

IN PRACTICE:

“TNT significantly improved lumbosacral plexus neuropathy, particularly those affecting the anal innervation,” the authors stated. “TNT is an effective and safe treatment that reverses neuropathy in FI [fecal incontinence] patients and thereby improves symptoms.”

SOURCE:

The study was presented by Karlo Fidel, MD, Augusta University Medical Center in Augusta, Georgia, at the American College of Gastroenterology (ACG) 2025 Annual Scientific Meeting, Phoenix, on October 27, 2025.

LIMITATIONS:

No limitations were discussed in the abstract.

DISCLOSURES:

The study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. Fidel reported having no relevant financial relationships. One author disclosed receiving research support from and consulting for several companies; a second disclosed consulting for multiple companies; and a third disclosed receiving grant support and serving in an advisory role. The remaining authors reported having no relevant financial relationships. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.