Percutaneous tibial nerve stimulation in the treatment of refractory overactive bladder syndrome and fecal Incontinence: A prospective Study

Introduction The etiology of idiopathic over active bladder (OAB), the prevalence and incidence of this disease is still not fully assessed. The symptoms of frequency urge with or without incontinence and nocturia can be debilitating and can have a significant impact on quality of life.

The primary therapies of OAB include bladder retraining and uro-therapeutical intervention including drinking assessments. Secondary treatment options are based on pharmaceutical drug therapies either with anticholinergic agents or a selective beta-3 adrenoreceptor agonist. Due to severe side effects the women´s compliance is rather low.

With contraindication to second line pharmaceutical treatment options classify for the intravesical botulinum A. toxin injection or percutaneous tibial nerve stimulation (PTNS)

Materials und Results The aim of this study was to investigate the effectiveness of PTNS in women with refractory OAB.PTNS was applied weekly for 12 weeks followed by TTNS at home 3 times per week. Subjective success rate was evaluated utilizing the German female pelvic floor questionnaire, the visual analogue scale and the micturition protocol pre - and post intervention. Demographics, comorbidities and urodynamic parameters were recorded.

21 patients were included with a mean age of 64 years and BMI of > 30 Kg/m2 (25 %). There was a significant improvementspre/post therapy (P. value < 0.001 and Cohen´s d estimate 0.74), for patients who do not respond to OAB medication therapy. No major complications have been reported.

Conclusion This prospective cohort study demonstrates that that PTNS is an effective treatment in women with refractory OABwith excellent durability if TTNS was continued.

Publication History

Article published online:
07 October 2020