Long-Term Durability of Percutaneous Tibial Nerve Stimulation for the Treatment of Overactive Bladder

Abstract

Statistically significant overactive bladder symptom improvement achieved with 12 weekly percutaneous tibial nerve stimulation treatments demonstrates excellent durability through 12 months. The durability of response demonstrates the effectiveness of percutaneous tibial nerve stimulation as a viable, long-term therapy for overactive bladder.

Role of percutaneous posterior tibial nerve stimulation either alone or combined with an anticholinergic agent in treating patients with overactive bladder

“…Urge incontinence episodes per day decreased from 3/day at baseline to 0.3/day at 12 weeks vs. 1.8/ day at baseline to 1.0/day for sham (p<0.001). [19] In a randomized, controlled study, Finazzi-Agro et al [17] reported that PTNS significantly increased voided volume than sham treatment (150-186 mL in the PTNS treatment group vs. 146-150 mL in the sham group, p<0.001). In a urodynamic study, Klingler et al [21] reported that PTNS increased the mean total bladder capacity from 197 mL at baseline (range 35-349 mL) to 252 mL (range 78-384 mL, p<0.01) after 12 weeks of therapy.…”

“…The earliest ones are case series or single-arm efficacy studies, [14][15][16] three are randomized, controlled trials, [9,17,18] and two are long-term follow-up studies of patients who were responders in the overactive bladder innovative therapy (OrBIT) and sham effectiveness in the treatment of overactive bladder symptoms (SUmiT) trials. [19,20] Over half of the patients receiving PTNS therapy in the SUmiT trial, a randomized, double-blinded, sham controlled study, reported moderate or marked improvement in bladder symptoms (54.5% in PTNS patients vs. 20.9% in sham, p<0.001). In addition, PTNS reduced the number of voids per day from 12.3 at baseline to 9.8 …”

Management of overactive bladder review: the role of percutaneous tibial nerve stimulation

“…Thus, it will be necessary to explore more information on long-term therapy. 19 Macdiarmid et al 45 evaluated the durability in long-term of PTNS in OAB by the continuation of the second phase of the overactive bladder innovative therapy trial (OrBIT) where 33 responders of the PTNS group received an additional nine months of PTNS treatment. There was significant (statistically) improvement of OAB symptoms with 12 weekly PTNS that demonstrated good durability of 12 months through.…”

“…This conclusion was obtained from 12 months mean improvements from the baseline in frequency, urge incontinence, nocturia, and voided. 45 In addition, there was sustained therapeutic effects of PTNS (STEP) study which was the continuation from Study of Urgent PC versus Sham Effectiveness in Treatment of Overactive Bladder Symptoms (SuMIT) evaluating long-term efficacy of PTNS. After successful 12 weekly treatments, patients continued with 14-week tapering protocol and personalized treatment plan.…”

Neuromodulation by surface electrical stimulation of peripheral nerves for reduction of detrusor overactivity in patients with spinal cord injury: A pilot study

“…[5][6][7][8] Improvement in bladder function was assessed by using either patient's own record of fluid intake, urine output and leaks (voiding diary), cystometrogram (CMG) or quality-of-life questionnaires. 5,6,8,9 In a multi-center study conducted using PTN stimulation by Govier et al, 3 urodynamics was used at the time of screening the patient for detrusor overactivity, the analyses of the results were based on voiding diary and quality of life questionnaire. They observed a 71% treatment success rate by considering multiple parameters such as reduction in voiding frequency, urge incontinence, improvement in quality of life and improvement in pain.…”