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Low Anterior Resection Syndrome (LARS)NCT07632196

Efficacy and Safety of Transcutaneous Posterior Tibial Nerve Stimulation on Fecal Continence in Patients Undergoing Surgery for Rectal Neoplasia

A study testing Posterior tibial nerve stimulation intervention group in people with Low Anterior Resection Syndrome (LARS) and Rectal Neoplasm Malignant, run by Althaia Xarxa Assistencial Universitària de Manresa at 2 sites in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Rectal neoplasia is one of the most prevalent cancers in Spain, and the treatment of choice is total mesorectal excision (TME), as it has demonstrated significant oncological improvements. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Posterior tibial nerve stimulation intervention group
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
84 participants
Where
2 sitesSpain
Study dates
6 Feb 2026to 31 Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients diagnosed with rectal neoplasia and who have undergone a high anterior rectal resection regardless of the surgical approach (open, laparoscopic, laparoscopic+TaTME or robotic+TaTME).

Who cannot join

  • Patients not operated or within active surveillance strategy programs (watch \& wait)
  • Patients with ostomy
  • Patients with contraindications to the use of the neurostimulator:
  • Pacemaker / Defibrillator / Other electronic devices
  • History of heart problems
  • Propensity to excessive bleeding (coagulopathies)
Show all 11Show fewer
  • Damage to the nervous system (epilepsy)
  • Current pregnancy
  • Infections or skin lesions
  • Severe vascular disorders
  • Active neoplasms.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Spain2 sites, 2 recruiting
  • Althaia Xarxa Assistencial Universitària de Manresa

    Manresa, Barcelona, 08243

    Anna Arnau, PhD, +34 93 875 93 00 ext. 3414, aarnau@althaia.cat

    Meritxell Font Prat, MD

    Recruiting
  • Xarxa Assistencial Universitària de Manresa, Althaia

    Manresa, Barcelona, 08243

    Meritxell Font, Medical doctor, +34 676131774, meritxell.fontprat@gmail.com

    Ignasi Puig, Medical doctor

    Recruiting

Other trials in Spain

About this study

Official title: Randomized Clinical Trial Assessing the Efficacy and Safety of Transcutaneous Posterior Tibial Nerve Stimulation on Fecal Continence in Patients Undergoing Surgery for Rectal Neoplasia

Rectal neoplasia is one of the most prevalent cancers in Spain, and the treatment of choice is total mesorectal excision (TME), as it has demonstrated significant oncological improvements. However, mesorectal excision is not without complications, and patients often experience altered bowel function in the form of low anterior resection syndrome (LARS), as well as erectile dysfunction. However, few studies evaluate faecal incontinence, as most focus on oncological outcomes.

The aim of our study is to evaluate the efficacy and safety of posterior tibial nerve stimulation on fecal incontinence, sexual dysfunction, and quality of life in patients who underwent to rectal surgery for rectal neoplasia.

It will be conducted a randomized clinical trial (1:1) with two arms: half of the patients will receive posterior tibial nerve stimulation, while the other half will undergo stimulation with subtherapeutic doses. Faecal incontinence will be assessed using the LARS and Wexner questionnaires, and quality of life and sexual function will be assessed using the Fecal Incontinence Quality of Life Scale (FIQLS) and the Colorectal Cancer Quality of Life Questionnaire (QLQ-CR38), at one month, six months and one year after surgery.

Being tested
Posterior tibial nerve stimulation intervention group, Control group
Keywords
total mesorectum excision, rectal neoplasm, randomised clinical trial, posterior tibial nerve stimulation, low anterior resection syndrome (LARS), life quality, Fecal Incontinence (FI)
Medical subject headings
Low Anterior Resection Syndrome, Rectal Neoplasms, Fecal Incontinence, Ejaculatory Dysfunction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Posterior tibial nerve stimulation intervention groupDevice

    In the intervention group, Beurer EM-49 digital neurostimulator will be used, with CE marking, and a dose of 20 Hertz (Hz) - 200 microseconds (μs) will be applied.

    As the control group and the intervention group, the pelvic floor rehabilitator will program the neurostimulator for each case and then they will be trained on how to perform the neurostimulation.

    The first session will be carried out with the rehabilitator to learn how it works and resolve doubts about its use, and later the sessions will be carried out at home.

    In both groups, a program for carrying out sessions will be indicated according to the following scheme:

    • From the 1st month to the 3rd month post-surgery: stimulation 3 times a week
    • From the 4th month to the 6th month post-surgery: stimulation 2 times a week
    • From the 7th to the 12th month post-surgery: 1 time a week
  • Control groupDevice

    In the intervention group, Beurer EM-49 digital neurostimulator will be used, with CE marking; and a dose of 80 Hertz (Hz) - 150 microseconds (μs) will be applied.

    As the control group and the intervention group, the pelvic floor rehabilitator will program the neurostimulator for each case and then they will be trained on how to perform the neurostimulation.

    In order to apply the therapy, the patient must sit down for the placement of the electrodes.

    It will be performed on 2 feet at the same time. The first session will be carried out with the rehabilitator to learn how it works and resolve doubts about its use, and later the sessions will be carried out at home.

    In both groups, a program for carrying out sessions will be indicated according to the following scheme:

    • From the 1st month to the 3rd month post-surgery: stimulation 3 times a week
    • From the 4th month to the 6th month post-surgery: stimulation 2 times a week
    • From the 7th to the 12th month post-surgery: 1 time a week
Study groups in NCT07632196
Study groupRoleWhat they receive
Intervention groupExperimentalPosterior tibial nerve stimulation with Beurer EM-49 digital neuroestimulator at complete doses
Receives: Device: Posterior tibial nerve stimulation intervention group
Control groupSham comparatorPosterior tibial nerve stimulation with Beurer EM-49 digital neuroestimulator at subtherapeutic doses
Receives: Device: Control group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Faecal incontinence (FI) - LARS 1st month

    Assessed by LARS questionnaire Low anterior resection syndrome (LARS): LARS scale consists of 5 questions: gas incontinence (0,4,7 points), liquid incontinence (0,3,3 points), stool frequency (4,2,0,5 points), defecation fractionation (0,9,11 points) and defecatory urgency (0, 11,16 points). The score range is between 0 and 42 points. Patients are categorized into three groups: no LARS (0 to 20 points), mild LARS (21 to 29 points) and severe LARS (30 to 42 points).

    Measured: 1st month post-surgery

  2. Faecal incontinence (FI) - LARS 6th month

    Assessed by LARS questionnaire Low anterior resection syndrome (LARS): LARS scale consists of 5 questions: gas incontinence (0,4,7 points), liquid incontinence (0,3,3 points), stool frequency (4,2,0,5 points), defecation fractionation (0,9,11 points) and defecatory urgency (0, 11,16 points). The score range is between 0 and 42 points. Patients are categorized into three groups: no LARS (0 to 20 points), mild LARS (21 to 29 points) and severe LARS (30 to 42 points).

    Measured: 6th month post-surgery

  3. Faecal incontinence (FI) - LARS 12th month

    Assessed by LARS questionnaire Low anterior resection syndrome (LARS): LARS scale consists of 5 questions: gas incontinence (0,4,7 points), liquid incontinence (0,3,3 points), stool frequency (4,2,0,5 points), defecation fractionation (0,9,11 points) and defecatory urgency (0, 11,16 points). The score range is between 0 and 42 points. Patients are categorized into three groups: no LARS (0 to 20 points), mild LARS (21 to 29 points) and severe LARS (30 to 42 points).

    Measured: 12th month post-surgery

  4. Feacal incontinence (FI) - Wexner 1st month

    Assessed by Wexner questionnaire. Wexner scale consists of 5 questions (range 0-4): incontinence of solid stools, incontinence of liquid stools, incontinence of gases, use of pads or diapers and alteration of social life. Depending on the frequency, a score of 0 to 4 is assigned. The score can range from 0 to 20 points, considering no incontinence as 0 to 2 points, mild incontinence as a result of 3 to 6 points, moderate incontinence as 7 to 11 points and severe incontinence as a result greater than or equal to 12 points.

    Measured: 1st month post-surgery

  5. Faecal incontinence (FI) - Wexner 6th month

    Assessed by Wexner questionnaire. Wexner scale consists of 5 questions (range 0-4): incontinence of solid stools, incontinence of liquid stools, incontinence of gases, use of pads or diapers and alteration of social life. Depending on the frequency, a score of 0 to 4 is assigned. The score can range from 0 to 20 points, considering no incontinence as 0 to 2 points, mild incontinence as a result of 3 to 6 points, moderate incontinence as 7 to 11 points and severe incontinence as a result greater than or equal to 12 points.

    Measured: 6th month post-surgery

  6. Faecal incontinece (FI) - Wexner 12th month

    Assessed by Wexner questionnaire. Wexner scale consists of 5 questions (range 0-4): incontinence of solid stools, incontinence of liquid stools, incontinence of gases, use of pads or diapers and alteration of social life. Depending on the frequency, a score of 0 to 4 is assigned. The score can range from 0 to 20 points, considering no incontinence as 0 to 2 points, mild incontinence as a result of 3 to 6 points, moderate incontinence as 7 to 11 points and severe incontinence as a result greater than or equal to 12 points.

    Measured: 12th month post-surgery

Secondary outcomes (10)
  1. Sexual impairment 1st month

    Assessed by QLQ-CR38 questionnaire (question 17-18 for both sexes, 20-21 for men and 22-23 for women).

    Each question can be answered from 1 to 4 points. And then is it calculated in the sexual impairment analysis (symptoms area)

    Measured: 1st month post-surgery

  2. Sexual impairment - 6th month

    Assessed by QLQ-CR38 questionnaire (question 17-18 for both sexes, 20-21 for men and 22-23 for women). Each question can be answered from 1 to 4 points. And then is it calculated in the sexual impairment analysis (symptoms area)

    Measured: 6th month post-surgery

  3. Sexual impairment - 12th month

    Assessed by QLQ-CR38 questionnaire (question 17-18 for both sexes, 20-21 for men and 22-23 for women). Each question can be answered from 1 to 4 points. And then is it calculated in the sexual impairment analysis (symptoms area)

    Measured: 12th month post-surgery

  4. Quality of life (QoL) - FIQLS 1st month

    Assessed by:

    -Fecal Incontinence Quality of Life Scale(FIQLS):composed of 29 items that evaluate 4 health dimensions:lifestyle(10 items),behavior(9 items),depression/self-esteem(7 items) and shame(3 items).Each item has a range from 1 to 5,with 1 being the minimum value for the quality of life state.

    Measured: 1st month post-surgery

  5. Quality of life (QoL) - FIQLS 6th month

    Assessed by:

    -Fecal Incontinence Quality of Life Scale(FIQLS):composed of 29 items that evaluate 4 health dimensions:lifestyle(10 items),behavior(9 items),depression/self-esteem(7 items) and shame(3 items).Each item has a range from 1 to 5,with 1 being the minimum value for the quality of life state

    Measured: 6th month post-surgery

  6. Quality of life (QoL) - FIQLS 12th month

    Assessed by:

    -Fecal Incontinence Quality of Life Scale(FIQLS):composed of 29 items that evaluate 4 health dimensions:lifestyle(10 items),behavior(9 items),depression/self-esteem(7 items) and shame(3 items).Each item has a range from 1 to 5,with 1 being the minimum value for the quality of life state

    Measured: 12th month post-surgery

  7. Quality of life (QoL) - QLQ-CR 38 1st month

    Assessed by:

    -Colorectal Cancer Quality of Life Questionnaire(QLQ-CR38):organized into 2 areas: 1.Functioning area,which includes the body image and sexual functioning scales and the items on enjoying sex and worrying about the future.2.Symptom area with scales for problems with urination,gastrointestinal symptoms,chemotherapy side effects,problems with defecation,problems with the stoma,sexual problems in men and women,and the weight loss item. All scores ranged 1 to 4, and then are lineal transformation is done (0 to 100). In the functioning area,a higher score indicates a better quality of life,while in the symptom area, a higher score indicates a worse quality

    Measured: 1st month

  8. Quality of life (QoL) - QLQ-CR38 6th month

    Assessed by:

    -Colorectal Cancer Quality of Life Questionnaire(QLQ-CR38):organized into 2 areas: 1.Functioning area,which includes the body image and sexual functioning scales and the items on enjoying sex and worrying about the future.2.Symptom area with scales for problems with urination,gastrointestinal symptoms,chemotherapy side effects,problems with defecation,problems with the stoma,sexual problems in men and women,and the weight loss item. All scores ranged 1 to 4, and then are lineal transformation is done (0 to 100). In the functioning area,a higher score indicates a better quality of life,while in the symptom area, a higher score indicates a worse quality

    Measured: 6th month post-surgery

  9. Quality of life (QoL) - QLQ-CR38 12th month

    Assessed by:

    -Colorectal Cancer Quality of Life Questionnaire(QLQ-CR38):organized into 2 areas: 1.Functioning area,which includes the body image and sexual functioning scales and the items on enjoying sex and worrying about the future.2.Symptom area with scales for problems with urination,gastrointestinal symptoms,chemotherapy side effects,problems with defecation,problems with the stoma,sexual problems in men and women,and the weight loss item. All scores ranged 1 to 4, and then are lineal transformation is done (0 to 100). In the functioning area,a higher score indicates a better quality of life,while in the symptom area, a higher score indicates a worse quality

    Measured: 12th month post-surgery

  10. Patient global impression of improvement (PGI-I)

    Assessed by PGI-I questionnaire.

    The Patient Global Improvement Visual Analogue Scale (PGI-I) will be used to allow patients to comparatively assess their degree of global improvement after undergoing posterior tibial nerve stimulation therapy. The scale in question has only one question that asks the patient to classify the degree of symptom relief obtained with the treatment according to the 7-point Likert scale. The higher the score, the better the perception of quality of life.

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Jun 2026
  2. Study start6 Feb 2026
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Dec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized clinical trial (1:1) with two arms
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
84 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07632196
Sponsor's protocol ID
CEIm 25/080
Status last verified
May 2026
First submitted
6 Feb 2026
Last updated
8 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: It is planned to publish the complete result data without providing specific participant data.

Questions about this trial

What is this clinical trial studying?

A study testing Posterior tibial nerve stimulation intervention group in people with Low Anterior Resection Syndrome (LARS) and Rectal Neoplasm Malignant, run by Althaia Xarxa Assistencial Universitària de Manresa at 2 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 8 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Meritxell Font (+34 676131774, meritxell.fontprat@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Faecal incontinence (FI) - LARS 1st month (time frame: 1st month post-surgery). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jun 2026.

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