Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy

Bhide, Alka; Tailor, Visha; Fernando, Ruwan; Khullar, Vik; Digesu, G. Alessandro

doi:10.1007/s00192-019-04186-3

Cited by 55 publications

(55 citation statements)

References 35 publications

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“…The PTN is a distal branch of the sciatic nerve that originates in the pelvis (L5–S3 spinal roots) and descends towards the lower extremities. [ 26 ] Stimulation of the PTN delivers retrograde neuromodulation to the sacral nerve plexus that controls the bladder function. TNS is a form of neuromodulation involving the use of electrical impulses to address urinary symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Treatment for overactive bladder

2021

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Background: We aim to compare the safety and effectiveness of transcutaneous tibial nerve stimulation (TTNS) versus percutaneous tibial nerve stimulation (PTNS) in treating overactive bladder. Methods: A systematical search on PubMed, Embase, clinicalTrial.gov, and Cochrane Library Central Register of Controlled Trials from January 1, 1999 to November 1, 2020 was performed. The primary outcomes were the changes in a 3-day voiding diary. Quality of life scores were also evaluated. Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) was applied to conduct all statistical analyses. Results: A total of 4 trials (2 randomized controlled trials, 1 retrospective study, and 1 before-after study) with 142 patients were eventually enrolled. Compared with PTNS, TTNS had a similar performance in the voiding frequency in 24 hours (mean difference [MD] = −0.65, 95% confidence interval [CI]: −1.35 to 0.05, P = .07), the number of urgency episodes in 24 hours (MD = 0.13, 95% CI: −0.36 to 0.62, P = .60), the number of incontinence episodes in 24 hours (MD = 0.01, 95% CI: −0.13 to 0.14, P = .93), as well as in the nocturia frequency (MD = −0.14, 95% CI: −0.52 to 0.24, P = .47). Moreover, comparable results were observed regarding HRQL scores ( P = .23) and incontinence quality of life scores ( P = .10) in both groups. The total complication rate in the current study was 2.1% (3/142). No adverse events were identified in the TTNS group. Conclusion: Current data supported that TTNS is as effective as PTNS for the treatment of overactive bladder, moreover, with no reported adverse events. However, the evidence is low-grade and well-designed prospective studies with a large sample size are warranted to verify our findings.

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Section: Discussionmentioning

confidence: 99%

“…TNS is a form of neuromodulation involving the use of electrical impulses to address urinary symptoms. [ 26 ] Two routines were usually applied during TNS, including transcutaneous and percutaneous approaches. Two RCTs comparing PTNS with sham stimulation have proved PTNS effective and acceptable.…”

Section: Discussionmentioning

confidence: 99%

Treatment for overactive bladder

2021

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“…Posterior tibial nerve stimulation involves the use of electrical impulses and is a form of neuromodulation employed to improve urinary symptoms 37 . This can be in the form of percutaneous tibial nerve stimulation (PTNS), which uses a needle, and transcutaneous tibial nerve stimulation (TTNS), which uses pads.…”

Section: Neuromodulationmentioning

confidence: 99%

“…An external control unit is worn around the ankle to activate the electrodes. This unit is worn six times a week for 30 minutes to activate treatment 37 , 38 . A study of 15 patients (13 female) showed a significant improvement in frequency, urgency, and urgency incontinence episodes at 3 months 38 .…”

Section: Neuromodulationmentioning

confidence: 99%

Recent advances in managing overactive bladder

et al. 2020

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Overactive bladder syndrome (OAB) is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency incontinence, in the absence of urinary tract infection or other obvious pathology. In this review, we focus on recent advances in the management of OAB. We examine the evidence on the effect of anticholinergic load on OAB patients. Advances in medical treatment include a new beta-3 agonist, vibegron, which is thought to have fewer drug interactions than mirabegron. Treatment of genitourinary syndrome of the menopause with oestrogens and ospemifene have also shown promise for OAB. Botulinum toxin has been shown to be an effective treatment option. We discuss the new implantable neuromodulators that are on the market as well as selective bladder denervation and laser technology.

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“…In the past 5 years, nearly 60 centers in China have carried out SNM clinical studies, and there are also several clinical articles published in China that report the efficacy and prognosis of SNM (Chen et al, 2014;Zhang et al, 2017). Researchers are also exploring other pelvic floor and peripheral nerves as new regulatory targets to achieve better efficacy and reduce associated complications, such as the pudendal nerve (Marinkovic et al, 2015) and the tibial nerve (Bhide et al, 2020). The pudendal nerve is one of the main nerves that stimulates pelvic floor muscles, external urethral meatus, the anal sphincter, and pelvic organs, and it is composed of nerve fibers emanating from S2 to S4 nerve roots.…”

Section: Introductionmentioning

confidence: 99%

Neuromodulation of the Pudendal Nerve Assisted by 3D Printed: A New Method of Neuromodulation for Lower Urinary Tract Dysfunction

Jiang

et al. 2021

Front. Neurosci.

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Electrical stimulation of peripheral nerves by implanted electrodes is an effective treatment for certain pelvic floor diseases. As well as intravesical electrical stimulation, this predominantly includes stimulation of the sacral nerve, tibial nerve, and pudendal nerve. The pudendal nerve is one of the main nerves that stimulate pelvic floor muscles, external urethral meatus, and the anal sphincter and pelvic organs, and it may have effects on frequent urination, urgency, dysuria, and perineal pain. It is difficult to locate because of its anatomical course, however, leading to difficulties fixing the electrode, which increases the difficulty of pudendal nerve electrical stimulation in clinical practice. In the current study 3D printed navigation was used to solve these problems. Combined with autopsy data and patient pelvic and nerve data, a personalized design was generated. Neural modulation of the pudendal nerve was achieved by implanting the lead with the guidance of 3D printed navigation. 3D printed navigation can maximize the phase II conversion rate, reduce the difficulty of surgery, shorten the operation time, reduce damage to additional organs and blood vessels, and increase the accuracy of electrode implantation, and it can be performed while the patient is awake. It is an accurate, reversible, efficient, and minimally invasive surgery.

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Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy

Cited by 55 publications

References 35 publications

Treatment for overactive bladder

Treatment for overactive bladder

Recent advances in managing overactive bladder

Neuromodulation of the Pudendal Nerve Assisted by 3D Printed: A New Method of Neuromodulation for Lower Urinary Tract Dysfunction

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