Del Río-Gonzalez, S., Aragon, I.M., Castillo, E., Milla-España, F., Galacho, A., Machuca, J., et al. (2017). Percutaneous Tibial Nerve Stimulation Therapy for Overactive Bladder Syndrome: Clinical Effectiveness, Urodynamic and Durability Evaluation. Urology. [Epub ahead of print].
OBJECTIVE:
To evaluate percutaneous tibial nerve stimulation (PTNS) effectiveness, durability and impact on the pathophysiology of overactive bladder syndrome (OAB) in patients who have been previously treated with antimuscarinics without success.
METHODS:
A prospective study that included 200 females diagnosed with OAB between 2007 and 2015 at Virgen de la Victoria University Hospital (Málaga, Spain) was conducted. OAB patients were treated with PTNS therapy after antimuscarinic treatment failed. To evaluate OAB symptoms clinical and urodynamic studies were performed before and after PTNS treatment. Treatment's success was defined as a reduction of clinical parameters by > 50% and an improvement of at least two urodynamic parameters by > 50%. The Kolmogorov-Smirnov test and Student's t test or Wilcoxon test were used based on the data. A linear correlation analysis and a multivariate linear regression analysis were performed to determine factors associated with the success of PTNS therapy.
RESULTS:
94% of patients experienced a positive response to PTNS considering clinical and urodynamic parameters. PTNS benefits were extended by 24-months. We identified day-time urinary frequency (DUF) (r= -0,165; p= 0,024; 95%CI, -0,248 to -0,018) and first sensation of bladder filling (1st SBF) (r= 0,208; p= 0,030; 95% CI, 0,001 to 0,028) as significant independent predictor factors for PTNS success.
CONCLUSIONS:
The current data confirmed a high effectiveness of PTNS improving OAB symptoms through 24 months. Furthermore, DUF and 1st SBF act as a significant independent predictor factors for PTNS success.
PMID:28687483
OI:10.1016/j.urology.2017.04.059
