Real-life patient experiences of TTNS in the treatment of overactive bladder syndrome

Abstract

Introduction and objectives: Overactive bladder syndrome (OAB) is defined as urinary urgency, with or without urgent urinary incontinence; it is often associated with urinary frequency and nocturia, in the absence of any pathological or metabolic conditions that may cause or mimic OAB. The aim of this study was to evaluate the long-term real-life adherence of transcutaneous tibial nerve stimulation (TTNS) in the treatment of OAB, patient satisfaction of the treatment, and reasons for quitting therapy. Materials and methods: In this single center study, all patients who had a positive effect on percutaneous tibial nerve stimulation (PTNS) and continued to receive home-based treatment with TTNS since 2012 were included for analysis. Patients were retrospectively asked to fill out a questionnaire regarding satisfaction, reasons for quitting, and additional or next line of therapy. Results: We included 42 patients for this study, 81% of these patients were female ( n = 34). The median age was 67 years (range 36–86). Most of the patients (64%, n = 27) were diagnosed with OAB wet. The median TTNS treatment persistence was 16 months (range 1–112 months). Reasons and percentages for stopping therapy were: 55% stopped treatment due to loss of effect, and 24% stopped because of preferring other type of neuromodulation. The mean satisfaction score (scale 1–10) in patients who continued TTNS was 6.2 ( n = 9, SD 1.30) versus 5.4 ( n = 29, SD 2.24) for patients who quit therapy. We did not find a statistically significant difference between the two groups ( p = 0.174). Conclusion: TTNS, although effective in the short-term, is not effective in the long-term. In combination with a low satisfaction rate among patients, there is a need for improvement in terms of OAB treatment modalities.

Adherence to Overactive Bladder Syndrome Treatments Recent Developments and Future Perspectives

“…The authors concluded that PTNS was effective in the short term although not effective in the longer term. 60 Similar discontinuation rates have been reported in a further study of 141 women with 53.2% discontinuing treatment at one year. When considering those women who discontinued treatment as treatment failures the overall success rate of maintenance therapy at one year was 30.7% to 42.9%.…”

“…The authors concluded that PTNS was effective in the short term although not effective in the longer term. 60 …”

Differences between brain responses to peroneal electrical transcutaneous neuromodulation and transcutaneous tibial nerve stimulation, two treatments for overactive bladder

“…Despite promising results in clinical trials, 22 real-life data have shown that most patients discontinue TTNS, due to lack of efficacy. 23 In contrast to TTNS, based on the clearly detectable specific motor response, peroneal eTNM® allows precise detection of the optimal stimulation point. In addition, several other technical features that distinguish peroneal eTNM® from TTNS are described elsewhere.…”

“…Therefore, the motor response to TTNS could be due to direct stimulation of the underlying muscle, rather than nerve stimulation. Despite promising results in clinical trials, 22 real‐life data have shown that most patients discontinue TTNS, due to lack of efficacy 23 …”

Patients’ Preferences and Expectations in Overactive Bladder: A Systematic Review

“…For instance, patients choosing SNM favoured an implanted device in upper buttock more than those preferring PTNS or Botox. Moreover, it has been recently reported that successful rate of SNM improves when the patient can interact with the device [ 22 ] while low side effects followed by the effectiveness on continence and micturition frequency had the greatest impact on patients when a SNM device was implanted [ 20 ]. Moreover, Fontaine et al evaluated 217 patients who failed medical treatment.…”