Management of refractory overactive bladder in children by transcutaneous posterior tibial nerve stimulation: A controlled study

Boudaoud, Nadia; Binet, Aurélien; Line, Antoine; Chaouadi, D.; Jolly, C.; Fiquet, Caroline; Ripert, T.; Merol, M.-L. Poli

doi:10.1016/j.jpurol.2014.09.013

Cited by 35 publications

(33 citation statements)

References 24 publications

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“…Though Patidar et al reported a cure rate of 67% and an improvement rate of 24% in the PTNS group, compared to 0% and 6%, respectively, in the sham group, 73 Boudaoud et al noted a similar clinical efficacy between their PTNS and sham groups. 74 Sacral neuromodulation with an implantable device, such as InterStim ® , is commonly performed in adults with refractory OAB, but thus far, the pediatric literature is scarce. In 2015, Schober et al concluded significant improvement in voiding dysfunction scores and in urodynamic parameters in a group of 23 children with OAB.…”

Section: Neuromodulationmentioning

confidence: 99%

Overactive bladder in children

Ramsay¹,

Bolduc²

2017

CUAJ

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Overactive bladder (OAB) is a highly prevalent disorder in the pediatric population. This condition is especially troublesome for pediatric patients and their families when associated with incontinence, since it negatively affects self-esteem and impairs children's development. From the patient's perspective, urgency and urge incontinence can have a significant impact, negatively affecting their quality of life. For a therapy to have true benefit, changes must not only be statistically significant, but must also be perceived as meaningful by the patient. A stepwise approach is favoured to treat this pathology, starting with behavioural therapy, followed by medical management, and eventually more invasive procedures.Antimuscarinic agents are the mainstay of medical treatment for OAB. Oxybutynin is the most commonly used antimuscarinic in the pediatric population. However, some patients have a suboptimal response to antimuscarinics and many experience bothersome side effects, which have been documented with all antimuscarinics to a significantly higher degree than placebo. Although there have been reports about the use of tolterodine, fesoterodine, trospium, propiverine, and solifenacin in children, to date, only oxybutynin has been officially approved for pediatric use by medical authorities in North America. This review will address alternative treatment options for pediatric patients presenting with OAB, from conservative measures to more invasive therapies.

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Section: Neuromodulationmentioning

confidence: 99%

Overactive bladder in children

Ramsay¹,

Bolduc²

2017

CUAJ

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“…The clinical results remained the same between both groups, underlining the potential placebo effect of any type of management in this population. (6) In the second study by Patidar et al a signi cant bene t of TTNS over sham therapy in a study population of 40 children with OAB was seen. 7Since the results of both trials are contradictive, we decided to set up a new similar RCT.…”

Section: Introductionmentioning

confidence: 93%

Clinical Efficacy of Transcutaneous Tibial Nerve Stimulation (TTNS) Versus Sham Therapy (Part I) and TTNS Versus Percutaneous Tibial Nerve Stimulation (PTNS) (Part Ii) on the Short Term in Children With the Idiopathic Overactive Bladder Syndrome: Protocol for Part I of the Two-fold Randomized Controlled TaPas Trial

Ghijselings

Renson

Walle

et al. 2020

Preprint

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Background: Transcutaneous tibial nerve stimulation (TTNS) and percutaneous tibial nerve stimulation (PTNS) are effective and safe therapies for the overactive bladder (OAB) syndrome in adults. However, few randomized sham-controlled trials have been conducted in a paediatric population. Both therapies have never been compared to our knowledge.. Aim: The aim of the complete study is twofold: 1) To assess the efficacy of TTNS therapy on bladder symptoms after 12 weeks of treatment in a paediatric population with idiopathic overactive bladder syndrome (iOAB) and/or nocturnal enuresis (part I). 2) To assess the effect of TTNS compared to PTNS (part II). In this article, we aim to present the protocol of the first part of the TaPaS trial (TTNS, PTNS, Sham therapy). Methods: Part I of the TaPaS trial is set up as a single-centre randomized-controlled trial. Children, aged from 5 to 12 years with iOAB and/or nocturnal enuresis, are assigned to two groups by computer-generated randomization: TTNS therapy (intervention) and sham therapy (controls). The primary outcome is the percentage difference in average voided volume (AVV) between baseline and after 12 weeks of treatment. Secondary endpoints are the percentage difference in supervoids volumes, number of urinary incontinence episodes/24 hours and in voiding frequency, the difference in parent reported outcomes between baseline and after 12 weeks of treatment and the duration of clinical response. Discussion: We hypothesize that TTNS is a non-inferior treatment for iOAB in children compared to PTNS therapy. Since literature is inconclusive about the efficacy of TTNS in a paediatric population, a sham controlled RCT on TTNS will be conducted (part I). A protocol for a prospective randomized sham-controlled trial has been developed. Enrolment has started in November 2018. Study completion of part I is expected by August 2021.Trial Registration: ClinicalTrials.gov NCT 04256876. Retrospectively registered on February 5, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04256876

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“…It was reported that, percutaneous tibial nerve stimulation can improve the sexual function of females with the overactive urinary bladder. Transcutaneous stimulation of the posterior tibial nerve (tibial nerve name distal to the lower border of popliteus muscle) was also reported to improve the conditions of overactive bladder in children (Patidar et al 2015), including the refractory cases (Boudaoud et al, 2015). The endoneurial microenvironment and the internal milieu include the endoneurial blood flow that represents a cornerstone of nerve function and the regenerative power after injury (Yasuda & Dyck, 1987).…”

Section: Introductionmentioning

confidence: 99%

The Tibial Nerve and Its Vasculature: An Anatomical Evaluation

Elbarrany

Altaf

2017

Int. J. Morphol.

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SUMMARY:The study has contributed to evaluate the tibial nerve and its vasculature anatomically. Ten preserved cadavers (5 male, 5 female) have been used for this study. Each cadaver was injected with red latex and through incisions the tibial nerve was exposed at the level of bifurcation of sciatic nerve. The tibial nerve in 85 % cadavers was located between middle and lower thirds at upper angle of popliteal fossa; whereas, in 15 % cadavers it was present below the piriformis muscle in gluteal region. The total length of the tibial nerve was at a mean of 65.26±14.42 cm in males and 64.79±67.61 cm in females, without significantly different. Its total diameter was at a mean of 5.51±1.55 mm, with a mean of 4.11±0.88 mm at the popliteal fossa and a mean of 3.24±0.81mm at its termination deep to the flexor retinaculum in male cadavers. In female; the means were 5.11±0.21 mm, 3.97±1.78 mm and 3.14 ± 0.03 mm respectively without significance difference. It was concluded that tibial nerve has sufficient and good blood supply. Moreover, it can be utilized as allogeneic vascularized nerve graft to repair sizable nerves after limb salvage.

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Management of refractory overactive bladder in children by transcutaneous posterior tibial nerve stimulation: A controlled study

Cited by 35 publications

References 24 publications

Overactive bladder in children

Overactive bladder in children

The Tibial Nerve and Its Vasculature: An Anatomical Evaluation

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