Obesity on the Efficacy of Bilateral Tibial Nerve Stimulation

Impact of Obesity on the Efficacy of Bilateral Tibial Nerve Stimulation in Obstructed Defecation

Obstructed defecation syndrome (ODS) is a common functional bowel disorder characterized by difficulty in stool evacuation. Bilateral posterior tibial nerve stimulation (BT PTNS) has emerged as a noninvasive, safe, and effective therapeutic option for functional ODS, improving symptom severity and quality of life.

Obesity is associated with altered pelvic floor mechanics, which may affect the response to neuromodulation therapy. However, the effect of obesity on BT PTNS outcomes in ODS has not been systematically evaluated. This study aims to fill this knowledge gap by comparing treatment efficacy between obese and non-obese patients.

Inclusion Criteria:

• Diagnosis of functional obstructed defecation (Rome IV criteria).
• Able to provide informed consent.
• BMI ≥30 kg/m² (obese group) or BMI <30 kg/m² (non-obese group).

Exclusion Criteria:

• Organic causes of constipation (e.g., colorectal cancer, inflammatory bowel disease).
• Previous pelvic floor surgery.
• Neurological disorders affecting bowel function.
• Pregnancy or lactation.
• Current use of other neuromodulation therapies.