The Investigation of Percutaneous Tibial Nerve Stimulation (PTNS) as a Minimally Invasive, Non-Surgical, Non-Hormonal Treatment for Overactive Bladder Symptoms

Abstract

Background: Overactive bladder (OAB) syndrome affects 10–15% of women, severely impacting their quality of life. First-line treatments include behavioural and physical therapy, and second-line medical treatments include medications such as vaginal oestrogen, anticholinergic medications, and ß3-adrenergic agonists—with potential adverse side effects including dizziness, constipation, and delirium, particularly affecting elderly populations. Third-line treatments include more invasive measures, including intradetrusor botulinum injections or sacral nerve modulation, with percutaneous tibial nerve stimulation (PTNS) being a potential alternative treatment. Aims: The aim of this study was to explore the long-term efficacy of PTNS treatment for OAB in an Australian cohort. Materials and Methods: This is a prospective cohort study. Patients underwent Phase 1 treatment, whereby women received PTNS treatment once per week for 12 weeks. Following Phase 1, women entered Phase 2, whereby they received 12 PTNS treatments over 6 months. Their response to treatment was measured by obtaining data before and after each phase using ICIQ-OAB and the Australian Pelvic Floor Questionnaire (APFQ). Results: Phase 1 included 166 women, with 51 completing Phase 2. There was a statistically significant reduction in urinary urgency (29.8%), nocturia (29.8%), incontinence (31.0%), and frequency (33.8%) compared to the baseline. Patients who completed Phase 2 also showed a statistically significant reduction in urinary frequency (56.5%). Conclusions: Overall, the results from this study are positive and support that PTNS is a minimally invasive, non-surgical, non-hormonal, and effective treatment for OAB. These results suggest that PTNS may be a second-line treatment for patients with OAB not responding to conservative management or for patients aiming to avoid surgical approaches.

Posterior Tibial Nerve Stimulation for the Treatment of Detrusor Overactivity in Multiple Sclerosis Patients: A Narrative Review

“…Randomized controlled studies show that PTNS has a success rate that is significantly higher than placebo. Compared to control groups, PTNS significantly improved bladder control and reduced urinary urgency and frequency in systematic reviews and meta-analyses [27]. The findings affirm the positive efficacy of PTNS as a minimally invasive, non-surgical, and non-hormonal treatment for OAB.…”

“…The findings affirm the positive efficacy of PTNS as a minimally invasive, non-surgical, and non-hormonal treatment for OAB. Furthermore, it has been demonstrated that PTNS has a long-lasting impact: patients report symptom improvement for one to three months following the procedure [27].…”