The effects of posterior tibial nerve stimulation on refractory overactive bladder syndrome and bladder circulation

Abstract

Aim: We aimed to evaluate if posterior tibial nerve stimulation (PTNS) exerts its effects on overactive bladder symptoms through changes in bladder circulation.

Materials and methods: Eighteen women who applied to Istanbul Medical Faculty with symptoms of urgency, frequency±urge incontinence and did not respond to anticholinergic treatment and behavioral modification were enrolled in the study. Weekly PTNS in 30-min sessions for 12 weeks was performed. Urogynecologic symptom assessment, 1-h pad test, bladder diary, King's Health Questionnaire (KHQ), and transvaginal Doppler ultrasonography were performed before and after treatment.

Results: Ten patients (55.5%) were cured, five (27.8%) improved, and no effect was observed in three (16.7%). No significant change was observed in systolic and diastolic flow rate, pulsatility index, resistive index, systolic/diastolic ratio and average flow rate. Significant decrease in frequency, urgency, urge incontinence, pad test results and increase in fluid intake was observed. There was a significant improvement in physical limitations and sleeping/energy domains of KHQ. No significant change was observed in urodynamics.

Conclusions: PTNS does not have any effect on the bladder circulation despite positive effects on bladder diary, pad test, and quality of life in overactive bladder syndrome.