Posterior tibial nerve stimulation as treatment for the overactive bladder

Abstract

Objective: To evaluate the efficacy of posterior tibial nerve stimulation (PTNS) as a treatment for the overactive bladder (OAB) resistant to medical treatment.

Patients and methods: The study included 60 patients, comprising 55 women (92%) and five men (8%) with a mean (SD) age of 41.4 (10.8) years, who presented to the Urology Department of Benha University Hospital from June 2010 to October 2012. All patients were assessed initially by taking a history, a physical examination, urine analysis, routine laboratory investigations, and a urodynamic evaluation in the form of flowmetry, cystometry, and a pressure-flow study in some cases. A voiding diary (daytime and night-time frequency, voiding volume, and leakage episodes) was completed by all patients, and all underwent 12 sessions of PTNS using a personal computer-based system, and were reassessed after the sixth session, at the end of the course, and at 3 and 6 months after the last session, using the same methods as in the baseline visit.

Results: There was a statistically significant improvement in all the variables assessed. No infection or failure of the PTNS mechanism was detected while using the technique, but there were rare instances of minor bleeding and a temporary painful feeling at the insertion site.

Conclusion: PTNS is safe, and gives statistically significant improvements in the patient's assessment of OAB symptoms.

Keywords: DO, detrusor overactivity; Neuromodulation; OAB, overactive bladder; Overactive bladder; PTN(S), posterior tibial nerve (stimulation); Posterior tibial nerve stimulation; RCT, randomised controlled trial; TENS, transcutaneous neuromodulation stimulation.