Patient‐reported outcomes in the setting of a randomized control trial on the efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome

Abstract

Aim: To compare the efficacy of transcutaneous tibial nerve stimulation (TTNS) with percutaneous tibial nerve stimulation (PTNS) regarding patientreported outcomes measures, specifically quality-of-life (QoL) improvement and patient's treatment benefit, on symptoms associated with overactive bladder (OAB). Methods: Patients with refractory OAB symptoms and detrusor overactivity were randomized to receive TTNS or PTNS for 12 weeks. Data from self-report OAB questionnaire short form (q-SF) and incontinence (I)-QoL questionnaires were collected pretreatment and at Weeks 6 and 12. Patients' self-perceived benefits on symptoms (treatment benefit scale, TBS) were also gathered. Mean change in scores within and between groups were estimated. Results: Sixty-eight adult patients (67.6% women) were included in the intention to treat analysis. Of those, 61 completed all questionnaires and were analyzed as per protocol. Statistically significant improvements in OAB-q-SF and I-QoL between baseline and end-of-treatment scores were observed in both TTNS and PTNS groups (p < .001), being the differences much higher than the minimal important difference in both questionnaires. The scores of the OAB-q-SF scales (symptoms bother and health-related QoL) showed no statistically significant differences between the two groups. Similarly, the differences regarding the I-QoL questionnaire were statistically nonsignificant either (p = .607). When assessing the treatment benefit on symptoms, TBS responses between groups showed no statistical differences. Conclusion: A significant improvement of QoL was observed in both TTNS and PTNS groups. However, no patient-reported outcomes measures scores support a difference between the two groups. Therefore, these findings along

Non‐inferior and more feasible transcutaneous tibial nerve stimulation in treating overactive bladder: A systematic review and meta‐analysis

“…Of the 15 articles remaining, eight were deemed ineligible after full text assessment, leaving seven eligible articles representing six RCTs (Figure 1). 5,14–19 …”

“…The nighttime micturition frequency data was reported by three RCTs 15,18,19 . A total of 56 individuals were allocated to TTNS, and 47 were allocated to control.…”

“…Symptom bother was reported by five RCTs. 5,14-16, 19 A total of 157 individuals were allocated to TTNS and 146 allocated to control. Of the 146 controls, 92 were allocated to anticholinergic drugs and 54 were allocated to PTNS.…”

Inhibitory effects of a smartphone‐controlled wearable transcutaneous tibial nerve stimulation device on bladder reflexes in anesthetized cats

“…17 In addition, researchers compared the effects of PTNS and TTNS and concluded that TTNS had the same effects as PTNS in relieving patients' relevant symptoms and improving the quality of life. 7,18 It has been recognized that TTNS combined with oxybutynin or low-dose trospium chloride is more effective than a single-drug regimen or TTNS alone. 19,20 Although extensive studies have supported the clinical use of TNS, consensus on the protocol and duration of stimulation treatment has not been reached.…”

“…A randomized controlled trial suggested that TTNS not only reduced urgency and nocturia episodes but also improved urodynamic parameters as well as symptom scores and health‐related quality of life scores in the treatment of patients with lower urinary tract symptom (LUTS) 17 . In addition, researchers compared the effects of PTNS and TTNS and concluded that TTNS had the same effects as PTNS in relieving patients' relevant symptoms and improving the quality of life 7,18 . It has been recognized that TTNS combined with oxybutynin or low‐dose trospium chloride is more effective than a single‐drug regimen or TTNS alone 19,20 .…”