Ruling Out Other Male-Based Maladies Before an OAB Diagnosis
Currently (and in the past) we have treated many male patients with PTNS. They all seem to have a different story. Differential diagnosis is the key to successful outcomes with PTNS.
Ruling Out Other Maladies
In all men you want to rule out UTI, prostatitis and review their lifestyle choices. Know the types and amounts of fluid intake ingested daily. Review all other bladder irritants including nicotine and medications that may be problematic – especially diuretics and blood pressure medications.
In the older male, you want to rule out an enlarged prostate. Treating that issue initially would be your first line of therapy. If they have no prostate, but overactivity of the bladder, you still want to rule out bladder cancer, stones or other diseases of the bladder and lower urinary tract. Know your patient's previous and current medical and surgical history (i.e., diabetes, CHF, Parkinson’s Disease, stroke, pelvic trauma, prostate surgery, pelvic radiation, etc.) and work from there. Make sure you are guided by the AUA/SUFU guideline for OAB. It is a very helpful and systematic algorithm of care.
The Possibility of Psychological Issues
In the younger adult male, in addition to ruling out all of the above, you might want to consider anxiety as an etiology, especially if they have an overactive bladder during the day but sleep all night. Psychological issues can affect many body systems. Urologic problems are certainly not exempt. Do yourself and your patients a favor. Be thorough, understand OAB etiology and treat appropriately. PTNS is just as safe and effective for male patients as it is for female patients.
This blog post reflects the opinions and experience of Leslie Wooldridge, a long-standing user of the Urgent PC Neuromodulation System, and was produced under a paid consulting agreement with Cogentix Medical.
Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Model is for illustrative purposes only. Urgent is a registered trademark of Cogentix Medical © 2015 Cogentix Medical. All rights reserved.