Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome

Wall, Liesbeth L de; Heesakkers, John

doi:10.2147/rru.s124981

Cited by 52 publications

(86 citation statements)

References 75 publications

(99 reference statements)

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“…The reported overall success rate in the literature ranges from 33 -71%. Success is defined as a more than 50% decrease in urgency and a 25% reduction of frequency and nocturia, respectively (7,8,9) . There is no other therapeutic option for overactive bladder syndrome patients that reaches similar success rates.…”

Section: Resultsmentioning

confidence: 99%

Successful Therapy of Overactive Bladder Syndrome with Percutaneous Tibial Nerve Stimulation: A Case Report

Keller¹,

Schmid²,

Haemmerle³

2017

IAM

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Introduction: Overactive bladder syndrome is defined as urgency with or without incontinence, often with frequency and nocturia but without infection or other pathology. For the patient, overactive bladder syndrome means an essential loss of quality of life. The therapeutic concept follows a graduated, stepwise scheme. The first step consists of behavioral treatment with bladder training and pelvic floor education as well as local estrogen therapy. Following inadequate response to these measures, it is often necessary to add anti-muscarinic drugs or beta-3 agonists. In case of medical contraindication or insufficient response to pharmacologic treatment, neuromodulation, i.e. percutaneous posterior tibial nerve stimulation, should be routinely offered to overactive bladder syndrome patients. Case Report: We present the case of an 81-year-old woman with long-lasting overactive bladder syndrome without incontinence. Behavioural treatment, local estrogen and anti-muscarinic therapy were unsatisfactory, therefore, an additional treatment employing percutaneous posterior tibial nerve stimulation was implemented. Under this regimen, the symptoms dramatically improved. Conclusion: The reported overall success rate of percutaneous posterior tibial nerve stimulation in the literature ranges from 33 -71%, with success being defined as more than a 50% decrease in urgency and a 25% reduction of frequency and nocturia, respectively. There is no other therapeutic option for overactive bladder syndrome patients, that reaches similar success rates. Percutaneous posterior tibial nerve stimulation should be routinely offered to overactive bladder syndrome patients and employed as an early step in the treatment of overactive bladder syndrome, sometimes in combination with or even before the introduction of medications.

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Section: Resultsmentioning

confidence: 99%

Successful Therapy of Overactive Bladder Syndrome with Percutaneous Tibial Nerve Stimulation: A Case Report

Keller¹,

Schmid²,

Haemmerle³

2017

IAM

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“…153,154 Percutaneous tibial NS (PTNS) and transcutaneous tibial NS are functionally comparable methods of stimulating the posterior tibial nerve at the ankle. 155,156 The techniques are similar to conventional TENS in the use of perceptible nonpainful stimulation, although the frequency is 20 Hz. The posterior tibial nerve is a mixed nerve originating from segments L4-S3, which overlap with the parasympathetic innervation to the bladder involving segments S2-S4.…”

Section: Remote Effects Of Nerve Stimulation In Nonpain Applicationsmentioning

confidence: 99%

<p>Remote Analgesic Effects Of Conventional Transcutaneous Electrical Nerve Stimulation: A Scientific And Clinical Review With A Focus On Chronic Pain</p>

Gozani

2019

JPR

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Background: Transcutaneous electrical nerve stimulation (TENS) is a safe, noninvasive treatment for chronic pain that can be self-administered. Conventional TENS involves stimulation of peripheral sensory nerves at a strong, non-painful level. Following the original gate-control theory of pain, stimulation is typically near the target pain. As another option, remote stimulation may also be effective and offers potential advantages. Objective: This narrative review examines mechanisms underlying the remote analgesic effects of conventional TENS and appraises the clinical evidence. Methods: A literature search for English-language articles was performed on PubMed. Keywords included terms related to the location of TENS. Citations from primary references and textbooks were examined for additional articles. Results: Over 30 studies reported remote analgesic effects of conventional TENS. The evidence included studies using animal models of pain, experimental pain in humans, and clinical studies in subjects with chronic pain. Three types of remote analgesia were identified: at the contralateral homologous site, at sites distant from stimulation but innervated by overlapping spinal segments, and at unrelated extrasegmental sites. Conclusion: There is scientific and clinical evidence that conventional TENS has remote analgesic effects. This may occur through modulation of pain processing at the level of the dorsal horn, in brainstem centers mediating descending inhibition, and within the pain matrix. A broadening of perspectives on how conventional TENS produces analgesia may encourage researchers, clinicians, and medical-device manufacturers to develop novel ways of using this safe, cost-effective neuromodulation technique for chronic pain.

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“…However, dry mouth, constipation, vision irregularity, headache, hypertension, and other cardiovascular safety issues are of concern to patients treated with these drugs [9]. Clinicians may offer more invasive posterior tibial nerve stimulation (PTNS), intradetrusor onabotu-linumtoxinA (Botox ® ) injection, and sacral neuromodulation (SNS) as third-line treatments for patients who are refractory to second-line therapies [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Laser Acupuncture Alleviates Symptoms and Improves Quality of Life in Women with Overactive Bladder: A Double‐Blind, Pilot Randomized Controlled Trial

Chang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Objective. The aim of this study was to investigate the clinical efficacy of laser acupuncture for the treatment of women with overactive bladder (OAB) in Taiwan. Methods. A double-blind randomized controlled trial was conducted on female patients with OAB symptoms referred from gynecologists, and subjects were divided into two groups using blocked randomization. LaserPan (RJ-Laser, Germany) was applied to seven selected acupuncture points. The subjects received laser acupuncture 3 times per week for 3 weeks, 9 sessions in total. Basic patient data, Overactive Bladder Symptom Score (OABSS), Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores were recorded prior to first treatment and at the end of 3rd, 6th, and 9th treatments. Results. Thirty patients were enrolled, and twenty-seven patients completed all treatments in this study. The OABSS total score of the experimental group decreased significantly by 3.13 (p≤0.001), 4.60 (p≤0.001), and 3.79 (p≤0.001) after 3rd, 6th, and 9th treatments, respectively, compared with that of the control group. The IIQ-7 score declined significantly from baseline by 4.57 (p=0.003) and 3.63 (p=0.023) after 3rd and 6th treatments, respectively, compared with that of the control group. Similarly, the UDI-6 score of the experimental group exhibited a significant decrease from baseline by 1.90 (p=0.042) and 2.25 (p=0.025) after 6th and 9th interventions, respectively, compared with that of the control group. Conclusions. This study demonstrates that laser acupuncture can alleviate OAB symptoms and improve quality of life. This noninvasive device could be an effective therapy for women with OAB.

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Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome

Cited by 52 publications

References 75 publications

Successful Therapy of Overactive Bladder Syndrome with Percutaneous Tibial Nerve Stimulation: A Case Report

Successful Therapy of Overactive Bladder Syndrome with Percutaneous Tibial Nerve Stimulation: A Case Report

<p>Remote Analgesic Effects Of Conventional Transcutaneous Electrical Nerve Stimulation: A Scientific And Clinical Review With A Focus On Chronic Pain</p>

Laser Acupuncture Alleviates Symptoms and Improves Quality of Life in Women with Overactive Bladder: A Double‐Blind, Pilot Randomized Controlled Trial

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