Efficacy and satisfaction with transcutaneous electrostimulation of the posterior tibial nerve in overactive bladder syndrome

Abstract

Objective: Overactive bladder is a disease with a high prevalence. The management is difficult, because different demographic, social or economic aspects converge. Our objective was to evaluate the efficacy and satisfaction in patients with overactive bladder treated with transcutaneous electrostimulation of the posterior tibial nerve. Methods: This was a prospective and descriptive study of 45 patients with overactive bladder (with or without detrusor overactivity) resistant to pharmacological treatment. Patients received a weekly session for 12 weeks, with a duration of 30 minutes for each of the sessions. There was a screening after 12 sessions, after which if there had been no response, treatment was suspended and maintenance sessions were not continued (six twice-monthly sessions and three monthly sessions). It was considered that the treatment had been effective when it was possible to decrease the number of events, except the maximum voiding volume, the objective of which was to increase. The results were evaluated using a 3-day voiding diary, an overactive bladder short form questionnaire and a satisfaction level questionnaire. Statistical analysis was performed using IBM SPSS Statistics version 19.0. Independent variables with a normal distribution were examined using the t-test. The Wilcoxon signed-rank test was used to compare the averages of the quantitative variables without a normal distribution. Satisfaction was analysed by a binary and ordinal regression analysis, univariate and multivariate. A P value less than 0.05 was considered statistically significant. Results: All the parameters of the study improved to a statistically relevant degree: frequency, nocturia, urgency, maximum voided volume, urge urinary incontinence. The overactive bladder short form questionnaire score improved but was not statistically significant. Conclusions: The use of transcutaneous electrostimulation of the posterior tibial nerve is a safe, effective and minimally invasive alternative in the treatment of overactive bladder when pharmacological treatment has failed. Patients had a good objective and subjective response in our study.

Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review

“…Finally, 19 studies [ 3 , 4 , 5 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] were included. Of these, nine were experimental [ 3 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], including eight RTCs [ 3 , 17 , 18 , 19 , 20 , 21 , 22 , 24 ] ( Table 2 ); four were observational studies [ 5 , 25 , 26 , 27 ] ( Table 3 ), and six were either systematic reviews [ 4 , 29 , 31 ] or a meta-analysis [ 28 ], while two encompassed both types of studies [ 30 , 32 ] ( Table 4 ).…”

“…Some of the additional complications to those observed in the analysis of results [ 3 , 19 , 21 , 23 , 26 , 28 , 30 , 32 ] were urinary tract infections in 10/17 studies (peer comparisons revealed that OnabotulinumtoxinA was associated with a greater incidence of urine infections vs. placebo, sacral neurostimulation (SNS), and PTNS); ranking in order of fewest infections: first PTNS, second SNS, third placebo, and fourth OnabotulinumtoxinA. Further, urine retention with a need for intermittent catheterization was found in 11/17, with peer comparisons showing that OnabotulinumtoxinA was associated with a greater incidence of retention vs. placebo, SNS, and PTNS; ranking in order of lowest incidence: first SNM, second placebo, third PTNS, and fourth OnabotulinumtoxinA [ 30 ].…”

“…Most of the studies included in this review report of the absence of adverse effects during treatment [ 5 , 17 , 18 , 20 , 22 , 24 , 25 ]. Studies that combine PTNS and TTNS therapy [ 17 ], and those in which TTNS therapy is involved [ 5 , 20 , 22 , 25 ], point out that there are no adverse effects after the use of this therapy, except for the study conducted by Moratalla-Charcos LM et al [ 26 ], who speak of mild pain on plantar flexion after the use of this technique.…”