Eficacia de la estimulación percutánea versus transcutánea del nervio tibial posterior en pacientes con vejiga hiperactiva

Barrera, Eyda Johanna Araque; Nuño, M. González; Mata, C. Tena-Dávila; Pozo, Ana Valiente del; Blanco, Herminda Gago; Elio, Ramón Usandizaga

doi:10.1016/j.rh.2013.11.003

Cited by 8 publications

(24 citation statements)

References 25 publications

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“…The present study compares both techniques in a controlled prospective randomized iOAB trial for the first time. The findings show that the response to transcutaneous neuromodulation was no lower than that reported for PTNS, as suggested in a previous retrospective study …”

Section: Discussionsupporting

confidence: 84%

“…To the authors knowledge, only one study conducted by Alfonso Barrera et al in a public hospital in Madrid has compared both therapeutic modalities (transcutaneous vs PTNS) in iOAB patients using observational methods. In that study, patients with a mean age of 64.5, similar to those in the current study, also showed an improvement in frequency with no statistical differences between groups.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: Randomized control trial

Ramírez‐García

Blanco‐Ratto²,

Kauffmann³

et al. 2018

Neurourology and Urodynamics

100

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Aim To evaluate the non‐inferiority of the transcutaneous electrical stimulation technique, as compared with the percutaneous therapy (PTNS), regarding the efficacy in symptoms and QoL improvement in patients with overactive bladder (iOAB). Methods Patients with overactive detrusor (DO) and persisting symptoms after first‐line or second‐line treatment were randomized to receive either transcutaneous therapy or PTNS 1 day a week (30 min at 20 Hz and 200 cycles/s) for 12 weeks. Data from a 3‐day voiding diary and a self‐reported QoL‐questionnaire were collected pre‐treatment and at week 12. Non‐inferiority was analyzed by estimating the mean change (95% confidence interval) of daytime micturition frequency. Statistical significance level was set at P < 0.05. Results Sixty‐eight patients were included (67.6% women), mean age 59.6 years (SD 16.1). According to ITT analysis, daytime frequency decreased in both groups without statistically significant differences between them at the end of the treatment (adjusted difference 0.8; 95%CI; −0.1; 1.7); nor were differences in symptoms improvement for the variables collected through the 3‐day voiding diary. Both techniques lessened urgency incontinence episodes by more than 50% and greatly improved the QoL. There were no relevant side effects and overall adherence to the treatment was 89.7%. Conclusions This is the first RCT that evaluates the efficacy of the transcutaneous technique compared to the PTNS, and demonstrates non‐inferiority in decreasing daytime frequency. Reduction in urgency incontinence episodes and improvement of QoL were also observed. These results and ease of application of transcutaneous neuromodulation may lead to a greater prescribing of this technique.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: Randomized control trial

Ramírez‐García

Blanco‐Ratto²,

Kauffmann³

et al. 2018

Neurourology and Urodynamics

100

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“…It was noted that 30 min/wk with a stimulation parameter of 20 Hz and 200 cycles/s was applied in 3 studies. [ 22 , 24 , 25 ] Notably, the study by Maurelli et al [ 25 ] was a before-after study in which TTNS was used as a maintenance treatment after PTNS. Since the 2 interventions were carried out in the 2 independent phases with available data, it was eventually selected.…”

Section: Resultsmentioning

confidence: 99%

Treatment for overactive bladder

2021

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Background: We aim to compare the safety and effectiveness of transcutaneous tibial nerve stimulation (TTNS) versus percutaneous tibial nerve stimulation (PTNS) in treating overactive bladder. Methods: A systematical search on PubMed, Embase, clinicalTrial.gov, and Cochrane Library Central Register of Controlled Trials from January 1, 1999 to November 1, 2020 was performed. The primary outcomes were the changes in a 3-day voiding diary. Quality of life scores were also evaluated. Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) was applied to conduct all statistical analyses. Results: A total of 4 trials (2 randomized controlled trials, 1 retrospective study, and 1 before-after study) with 142 patients were eventually enrolled. Compared with PTNS, TTNS had a similar performance in the voiding frequency in 24 hours (mean difference [MD] = −0.65, 95% confidence interval [CI]: −1.35 to 0.05, P = .07), the number of urgency episodes in 24 hours (MD = 0.13, 95% CI: −0.36 to 0.62, P = .60), the number of incontinence episodes in 24 hours (MD = 0.01, 95% CI: −0.13 to 0.14, P = .93), as well as in the nocturia frequency (MD = −0.14, 95% CI: −0.52 to 0.24, P = .47). Moreover, comparable results were observed regarding HRQL scores ( P = .23) and incontinence quality of life scores ( P = .10) in both groups. The total complication rate in the current study was 2.1% (3/142). No adverse events were identified in the TTNS group. Conclusion: Current data supported that TTNS is as effective as PTNS for the treatment of overactive bladder, moreover, with no reported adverse events. However, the evidence is low-grade and well-designed prospective studies with a large sample size are warranted to verify our findings.

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“…Different studies have reported the efficacy of TTNS ES and PTNS in treating refractory OAB, 8,19 but outcomes on QoL are scarce. Findings from our previous paper showed that the objective results from the bladder diary (voiding frequency, urgency incontinence episodes) were similar after both modalities of tibial nerve stimulation 8 .…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported outcomes in the setting of a randomized control trial on the efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome

Ramírez‐García

Kauffmann²,

Blanco‐Ratto³

et al. 2020

Neurourology and Urodynamics

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Aim: To compare the efficacy of transcutaneous tibial nerve stimulation (TTNS) with percutaneous tibial nerve stimulation (PTNS) regarding patientreported outcomes measures, specifically quality-of-life (QoL) improvement and patient's treatment benefit, on symptoms associated with overactive bladder (OAB). Methods: Patients with refractory OAB symptoms and detrusor overactivity were randomized to receive TTNS or PTNS for 12 weeks. Data from self-report OAB questionnaire short form (q-SF) and incontinence (I)-QoL questionnaires were collected pretreatment and at Weeks 6 and 12. Patients' self-perceived benefits on symptoms (treatment benefit scale, TBS) were also gathered. Mean change in scores within and between groups were estimated. Results: Sixty-eight adult patients (67.6% women) were included in the intention to treat analysis. Of those, 61 completed all questionnaires and were analyzed as per protocol. Statistically significant improvements in OAB-q-SF and I-QoL between baseline and end-of-treatment scores were observed in both TTNS and PTNS groups (p < .001), being the differences much higher than the minimal important difference in both questionnaires. The scores of the OAB-q-SF scales (symptoms bother and health-related QoL) showed no statistically significant differences between the two groups. Similarly, the differences regarding the I-QoL questionnaire were statistically nonsignificant either (p = .607). When assessing the treatment benefit on symptoms, TBS responses between groups showed no statistical differences. Conclusion: A significant improvement of QoL was observed in both TTNS and PTNS groups. However, no patient-reported outcomes measures scores support a difference between the two groups. Therefore, these findings along

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Eficacia de la estimulación percutánea versus transcutánea del nervio tibial posterior en pacientes con vejiga hiperactiva

Cited by 8 publications

References 25 publications

Efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: Randomized control trial

Efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: Randomized control trial

Treatment for overactive bladder

Patient‐reported outcomes in the setting of a randomized control trial on the efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome

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