Evaluation of Percutaneous Tibial Nerve Stimulation for Treatment of Refractory Painful Bladder Syndrome

Ragab, Maged; Tawfik, Ahmad M.; El-Enen, Mohamed Abo; Nady, Mohamed M. El; El‐Gamal, Osama M.; El-Kordy, Mohamed; Gameel, Tarek; Rasheed, Mohamed

doi:10.1016/j.urology.2015.06.041

Cited by 20 publications

(12 citation statements)

References 20 publications

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“…All three RCTs demonstrated a statistically significant reduction in pain scores, with the mean reduction of score ranging from 3.3 to 5.3/10; no significant reduction was seen in control groups (no treatment or sham PTNS) [23][24][25]. In two of three non-RCTs, there was a significant reduction in pain score following treatment for CPP and IC [26,28], but the third study demonstrated no significant improvement in pain for BPS (Table 3) [27]. One RCT evaluating long-term effect of PTNS found that the improvement in pain score in PTNS group was maintained at 6-mo follow-up [24].…”

Section: Benefits and Harms Of Ptnsmentioning

confidence: 92%

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Benefits and Harms of Electrical Neuromodulation for Chronic Pelvic Pain: A Systematic Review

Cottrell

Schneider

Goonewardene

et al. 2020

European Urology Focus

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Chronic pelvic pain (CPP) is chronic or persistent pain perceived in structures related to the pelvis of men and women. These individuals may suffer significant distress and detriment to their daily living and quality of life. Neuromodulation may provide an effective treatment option in patients with CPP refractory to standard treatment, reducing pain and improving quality of life with an acceptable rate of complications. However, study quality is insufficient for a more certain conclusion, and therefore larger-scale, well-designed, and powered randomized controlled trials with long-term outcomes are needed.

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Section: Benefits and Harms Of Ptnsmentioning

confidence: 92%

“…Six studies, three RCTs, and three non-RCTs evaluated the efficacy of PTNS in CPP [23][24][25][26][27][28]. Follow-up ranged from 12 to 24 wk.…”

Section: Benefits and Harms Of Ptnsmentioning

confidence: 99%

Benefits and Harms of Electrical Neuromodulation for Chronic Pelvic Pain: A Systematic Review

Cottrell

Schneider

Goonewardene

et al. 2020

European Urology Focus

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“…In contrast with these positive findings, Zhao et al (2008) reported no significant change in the VAS pain score of BPS patients after a 10-week trial of PTNS in an open prospective trial, though significant improvement in bladder volume was noted, along with complete pain resolution in a single subject and statistically significant improvements in other secondary measures, such as the Interstitial Cystitis Problem Index and the O’Leary/Sant Interstitial Cystitis Problem Index [ 44 ]. Subsequently, this result was echoed in a trial by Regab and colleagues where they reported no effect on BPS symptoms following intermittent PTNS after 0, six, and 12 weeks of treatment [ 45 ]. Using a slightly different treatment approach, Baykal et al found that PTNS when used in combination with glycosaminoglycan replacement therapy (intravesical heparin) was effective in improving pain scores and bladder capacity in refractory BPS patients (10 female, two male) who had failed “more than one classical therapy” [ 43 ].…”

Section: Neuromodulation For Pelvic-pain Syndromesmentioning

confidence: 97%

Neuromodulation for Pelvic and Urogenital Pain

2018

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Chronic pain affecting the pelvic and urogenital area is a major clinical problem with heterogeneous etiology, affecting both male and female patients and severely compromising quality of life. In cases where pharmacotherapy is ineffective, neuromodulation is proving to be a potential avenue to enhance analgesic outcomes. However, clinicians who frequently see patients with pelvic pain are not traditionally trained in a range of neuromodulation techniques. The aim of this overview is to describe major types of pelvic and urogenital pain syndromes and the neuromodulation approaches that have been trialed, including peripheral nerve stimulation, dorsal root ganglion stimulation, spinal cord stimulation, and brain stimulation techniques. Our conclusion is that neuromodulation, particularly of the peripheral nerves, may provide benefits for patients with pelvic pain. However, larger prospective randomized studies with carefully selected patient groups are required to establish efficacy and determine which patients are likely to achieve the best outcomes.

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“…27 In a smaller study of 20 women with refractory IC/BPS; VAS, day time frequency, nocturia, voided volume, and ICPI were similar to baseline following 12 weeks of PTNS, and only 10% of patients reported positive global response. 28 In a study of 18 women, despite lack of improvement in VAS pain scores, twice-weekly PTNS for 10 weeks was associated with improvements in nocturnal bladder volume and OLS. 29 While not specifically studied for IC/BPS, in a prospective study of 24 women with chronic pelvic pain, PTNS improved pain intensity and frequency, compared to control.…”

Section: Percutaneous Tibial Nerve Stimulation (Ptns)mentioning

confidence: 98%

Pathophysiology, assessment, and treatment of overactive bladder symptoms in patients with interstitial cystitis/bladder pain syndrome

Dobberfuhl

2022

Neurourology and Urodynamics

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Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is prevalent, difficult to treat, and has close symptom overlap with overactive bladder (OAB). A review of the pathophysiology, assessment, and treatment of IC/BPS patients with overlapping OAB symptoms has not been summarized recently in the published literature. Methods A review of the published literature on the overlap of IC/BPS and OAB was conducted using MeSH terminology (1992–2022). Results The pathophysiology of IC/BPS is not fully understood. Animal research has found the bladder trigone and base are richly populated by afferent fibers, including many small unmyelinated C‐fibers that may be upregulated in IC/BPS. Successful therapies with multimodal effects on OAB symptoms in patients with IC/BPS are likely to exert beneficial effects on both pain and lower urinary tract symptoms. Potentially efficacious therapies for the treatment of OAB in IC/BPS include pelvic floor physical therapy, oral pharmacotherapy (antimuscarinics and beta‐3 agonists), sacral neuromodulation, percutaneous tibial nerve stimulation, and botulinum toxin A (BTA). Antimuscarinics and beta‐3 agonists have yielded partial efficacy in IC/BPS, although may help differentiate symptoms of OAB from those associated with IC/BPS. The transvaginal trigone treatment (T3) intradetrusor injection approach allows for delivery of therapeutics to the bladder without the need for a cystoscope and appears to be feasible. Conclusions Further research is needed to understand the pathophysiology of IC/BPS and symptom overlap with OAB, which in turn should enable the development of more personalized therapeutics.

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Evaluation of Percutaneous Tibial Nerve Stimulation for Treatment of Refractory Painful Bladder Syndrome

Cited by 20 publications

References 20 publications

Benefits and Harms of Electrical Neuromodulation for Chronic Pelvic Pain: A Systematic Review

Benefits and Harms of Electrical Neuromodulation for Chronic Pelvic Pain: A Systematic Review

Neuromodulation for Pelvic and Urogenital Pain

Pathophysiology, assessment, and treatment of overactive bladder symptoms in patients with interstitial cystitis/bladder pain syndrome

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