Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis

Wang, Menghua; Jian, Zhongyu; Ma, Yucheng; Jin, Xi; Li, Hong; Wang, Kunjie

doi:10.1007/s00192-020-04429-8

Cited by 42 publications

(25 citation statements)

References 42 publications

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“…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 ).…”

Section: Resultsmentioning

confidence: 99%

“…In other studies [ 23 , 32 ], upon combining PTNS with drugs, 35/53 participants completed the satisfaction survey after treatment, 66% of whom preferred to continue with maintenance treatment, with a mean interval of 44.4 days (7–155 days) and frequency of sessions of 1.1 months; attendance was observed if there were symptoms of OAB, while patients with multiple sclerosis had the possibility of returning [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…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 ].…”

Section: Resultsmentioning

confidence: 99%

“…It is worth highlighting the improvements in UI reflected in the systematic review conducted by Booth J et al [ 4 ], when combining TTNS therapy with pelvic floor exercises or behavioral treatment, as well as the results observed in the systematic review and meta-analysis performed by Wang M et al, as regards the reduction in the number of episodes of UI and UUI per day through PTNS therapy [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Background: Percutaneous electrical stimulation and transcutaneous electrical stimulation (PTNS and TTNS) of the posterior tibial nerve are internationally recognized treatment methods that offer advantages in terms of treating patients with overactive bladder (OAB) who present with urinary incontinence (UI). This article aims to analyze the scientific evidence for the treatment of OAB with UI in adults using PTNS versus TTNS procedures in the posterior tibial nerve. Methods: A systematic review was conducted, between February and May 2021 in the Web of Science and Scopus databases, in accordance with the PRISMA recommendations. Results: The research identified 259 studies, 130 of which were selected and analyzed, with only 19 used according to the inclusion requirements established. The greatest effectiveness, in reducing UI and in other parameters of daily voiding and quality of life, was obtained by combining both techniques with other treatments, pharmacological treatments, or exercise. Conclusions: TTNS has advantages over PTNS as it is more comfortable for the patient even though there is equality of both therapies in the outcome variables. More research studies are necessary in order to obtain clear scientific evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Transcutaneous electrical nerve stimulation (TENS) of the tibial nerve is a non-invasive, safe, low-cost, easy-to-apply method, with good adherence among patients, which helps to reduce symptoms of urgency, incontinence, daily urinary frequency, and nocturia (1)(2)(3). In the literature, authors describe good results with this therapy for treating urinary symptoms, in addition to enhanced quality of life and improved urodynamic measurements in patients with overactive bladder (4).…”

Section: ' Introductionmentioning

confidence: 99%

Comparison of transcutaneous electrical tibial nerve stimulation for the treatment of overactive bladder: a multi-arm randomized controlled trial with blinded assessment

Pierre¹,

Friso²,

Casarotto³

et al. 2021

Clinics

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To compare the effectiveness of tibial nerve transcutaneous electrical nerve stimulation (TENS) for an overactive bladder, considering the sites of application and frequency of attendance. METHODS: This multi-arm randomized controlled trial enrolled 137 adult women (61.0±9.0 years) with overactive bladder from a university hospital. They underwent 12 sessions of 30-min TENS application and were assigned to five groups: one leg, once a week (n=26); one leg, twice a week (n=27); two legs, once a week (n=26); two legs, twice a week (n=28); and placebo (n=30). Symptoms of overactive bladder and its impact on quality of life were evaluated before and after 6 or 12 weeks of treatment using the Overactive Bladder Questionnaire-V8 and voiding diary. ClinicalTrials.gov: NCT01912885. RESULTS: The use of one leg, once a week TENS application reduced the frequency of urgency episodes compared with the placebo (1.0±1.6 vs. 1.4±1.9; p=0.046) and frequency of incontinence episodes compared with the placebo (0.7 ± 1.4 vs.1.4 ± 2.2; po0.0001). The one-leg, twice a week protocol decreased the urinary frequency compared with the two legs, once a week protocol (8.2 ± 3.5 vs. 9.0 ± 5.1; p=0.026) and placebo (8.2±3.5 vs. 7.9±2.7; p=0.02). Nocturia improved using the two legs, once a week protocol (1.5±1.8) when compared with the one leg, twice a week protocol (1.9±2.0) and placebo (1.7±1.6) (p=0.005 and p=0.027, respectively). Nocturia also improved using the two legs, twice a week protocol when compared with the one leg, twice a week protocol (1.3 ± 1.2 vs.1.9 ± 2.0; p=0.011). CONCLUSION: One-leg stimulation improved the daily urinary frequency, urgency, and incontinence, and the two-leg stimulation once and twice weekly improved nocturia.

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Does response to percutaneous tibial nerve stimulation predict similar outcome to sacral nerve stimulation?

Kapriniotis

Jenks

Toia

et al. 2022

Neurourology and Urodynamics

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Aims: Percutaneous tibial nerve stimulation (PTNS) is a simple neuromodulation technique to treat an overactive bladder. It is unclear whether the response to PTNS would suggest a similar response to sacral nerve stimulation (SNS), and whether PTNS could be utilized as an alternative test phase for an SNS implant. This study assessed whether PTNS response was a reliable indicator for subsequent SNS trials. Methods: We performed a retrospective review of the hospital databases to collect all patients who had PTNS and who subsequently had an SNS trial in two tertiary hospitals from 2014 to 2020. Response to both interventions was assessed.A 50% reduction in overactive symptoms (frequency−volume charts) was considered a positive response. McNemar's tests using exact binomial probability calculations were used. The statistical significance level was set to 0.05.Results: Twenty-three patients who had PTNS subsequently went on to a trial of SNS. All patients except one had previously poor response to PTNS treatment. Eight of them also failed the SNS trial. However, 15 patients (including the PTNS responder) had a successful SNS trial and proceeded with the second-stage battery implantation. The difference in response rates between the PTNS and SNS trial was statistically significant (p < 0.001). Conclusions: Poor response to PTNS does not seem to predict the likelihood of patients responding to SNS. A negative PTNS trial should not preclude a trial of a sacral nerve implant. The predictive factors for good and poor responses will be the subject of a larger study.

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Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis

Cited by 42 publications

References 42 publications

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

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

Comparison of transcutaneous electrical tibial nerve stimulation for the treatment of overactive bladder: a multi-arm randomized controlled trial with blinded assessment

Does response to percutaneous tibial nerve stimulation predict similar outcome to sacral nerve stimulation?

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