Role of percutaneous posterior tibial nerve stimulation either alone or combined with an anticholinergic agent in treating patients with overactive bladder

Kızılyel, Sadık; Karakeçi, Ahmet; Ozan, Tunç; Unus, Ihsan; Barut, Osman; Onur, Rahmi

doi:10.5152/tud.2015.94210

Cited by 13 publications

(16 citation statements)

References 24 publications

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“…Four prospective studies have evaluated percutaneous tibial nerve stimulation (PTNS) in combination with anticholinergic medications (either tolterodine or solifenacin; Table ) . All four studies include fewer than 40 patients, though universally report that combination therapy improves urinary frequency, urgency, and urge incontinence outcomes compared to either anticholinergic monotherapy or PTNS monotherapy.…”

Section: Resultsmentioning

confidence: 99%

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Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Kasman

Stave

Elliott

2019

Neurourology and Urodynamics

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Aims Overactive bladder (OAB) affects over 17% of the population and significantly effect the health‐related quality of life. The treatments for OAB include first line (lifestyle modification, pelvic floor muscle training), second line (anticholinergic or beta‐3 agonist medications), and third line therapies (intradetrusor botulinum toxin injection, sacral neurostimulation [SNM], or percutaneous tibial nerve stimulation [PTNS]). For those with urinary incontinence secondary to OAB, complete continence is the goal of therapy, though cure rates are only 5% to 40%. The use of combination therapies can be employed in refractory OAB, however, the efficacy of pooled modalities is relatively unknown. Our objective was to determine the volume of data supporting combination therapy in treating OAB. Methods We systematically reviewed PubMed, EMBASE, the Cochrane Library, and Google Scholar for articles published before October 2018. Each was independently reviewed by two reviewers and examined in detail if they met inclusion criteria. Results A total of 32 studies met inclusion criteria and were reviewed. Most large prospective studies evaluated combinations of medications with behavioral therapy or medications together. Combination therapy studies of third‐line treatments were rare and centered on medication with PTNS. No studies examined intradetrusor botulinum toxin injections in combination with another therapy and only one retrospective study briefly examined SNM therapy in combination with medication. Conclusion Combination therapy, with certain first, second, and third‐line OAB therapies, appears to be efficacious. There is a further need for carefully designed combination therapy studies, particularly those including third line modalities.

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Section: Resultsmentioning

confidence: 99%

Section: Posterior Tibial Nerve Stimulation With Medicationsmentioning

confidence: 99%

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Kasman

Stave

Elliott

2019

Neurourology and Urodynamics

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“…Studies performed on combination therapy in patients with OAB showed its effectiveness without demonstrating an increase in side effects: Bolduc et al, Kosilov et al ( 7 , 13 ), assessed combination of two anticholinergic drugs; Abrams et al ( 8 ) assessed the combination of an anticholinergic with the β3-adrenoceptor agonist Mirabegron. Mattiasson et al ( 10 ) combined tolterodine with simplified bladder training with an improvement on voiding frequency and voided volume; Curran et al ( 14 ) achieved better results by combining anticholinergic with behavioural modifications; Souto et al, Kikilyel et al ( 11 , 12 ), assessed combination of electrical stimulations of the posterior tibial nerve versus respectively, oxybutinin and tolterodine. Amend et al ( 15 ) and Abrams et al ( 8 ) explained the success respectively of the combination of two anticholinergic drugs and of an anticholinergic with the β3-adrenoceptor agonist Mirabegron, by different receptor selectivity and by receptor interaction on different bladder wall regions.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years several studies have shown that a combination of two different anticholinergic or one anticholinergic combined with the β3-adrenoceptor agonist Mirabegron may improve efficacy in the treatment of OAB symptoms while also reducing the side effects ( 8 ). Furthermore, although the available data does not allow definitive evaluation ( 9 ), promising results were observed with an anticholinergic combined with bladder training, electric stimulation or percutaneous tibial nerve stimulation ( 10 - 12 ). The aim of this study was to assess the efficacy and the long term durability of Solifenacin (SS) and percutaneous tibial nerve stimulation (PTNS) administered alone or in combination in the treatment of women with OAB syndrome.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and durability of solifenacin versus percutaneous tibial nerve stimulation versus their combination for the treatment of women with overactive bladder syndrome: a randomized controlled study with a follow-up of ten months

Vecchioli-Scaldazza¹,

Morosetti²

2018

Int. braz j urol.

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PurposeTo assess effectiveness and durability of Solifenacin (SS) versus tibial nerve stimulation (PTNS) versus combination therapy (PTNS + SS) in women with overactive bladder syndrome (OAB).Materials and Methods105 women with OAB were divided randomly into three groups of 35 patients each. In group A women received SS, in group B women underwent PTNS, in group C women underwent combination of PTNS + SS. Improvements in OAB symptoms were assessed with OABSS questionnaire; patients’ quality of life was assessed with OAB-q SF questionnaire. Evaluation of effectiveness of treatments was performed with PGI-I questionnaire. OABSS and PGI-I were also assessed monthly for ten months.ResultsAll treatments were effective on symptoms. PTNS showed a greater effectiveness than SS, but PTNS + SS was more effective than SS and PTNS. Furthermore, PTNS + SS showed a greater duration of effectiveness than PTNS and SS.ConclusionsCombination of PTNS with SS showed more effectiveness and more durability than PTNS and SS alone.

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“…[ 9 10 ] A recent publication suggested that percutaneous tibial nerve stimulation alone or in combination with anticholinergic could be a harmless, simple, and negligibly aggressive. [ 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Is there any Relationship Between Bladder Trabeculation and Efficacy and Safety of Intravesical Botulinum Toxin A Injection in Refractory Idiopathic Overactive Bladder Women?

et al. 2017

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Background:Intradetrusor injection of botulinum toxin A (BTX-A) might serve as a minimally invasive substitute in patients with refractory idiopathic overactive bladder (RIOAB). The aim of this study was to evaluate the clinical outcomes related to two different doses of abo-BTX-A (AboBTX-A) in patients with RIOAB.Materials and Methods:This prospective clinical trial was performed on 55 women with RIOAB. After determination of trabeculation grade, 300 (no or mild) or 500 (moderate or severe) unit of AboBTX-A (Dysport) was intravesicaly injected. Before 1, 3, and 6 months after intervention, lower urinary tract symptoms during 24 h were recorded.Results:Of the study population, 62% had severe bladder trabeculation. The mean duration of overactive bladder (OAB) was 1.76 versus 5.85 years, for no or mild versus severe trabeculation, respectively. After injections of 300- and 500-unit dosage, there were 19% and 26% early complications such as urinary retention. There was a statistically significant difference between the two groups in OAB score after 1 month (P < 0.001) and duration of OAB symptoms, over three follow-up times (P < 0.001). The mean preinjection OAB scores between patients with and without recurrence were statistically significant (29.36 vs. 25.07; P < 0.03). Urinary tract infection as a late complication was distinguished in four patients.Conclusion:In RIOAB, by adjusted dosage of AboBTX-A related to the grade of bladder trabeculation, in addition to maintain efficacy, consequent complications might not be affected by dosage and the drug dosage could be increased to nearly 60% with less concern associated to complication

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Role of percutaneous posterior tibial nerve stimulation either alone or combined with an anticholinergic agent in treating patients with overactive bladder

Abstract: Objective: To evaluate the efficacy of percutaneous tibial nerve stimulation (PTNS), either alone or combined with an anticholinergic agent, in treating patients with an overactive bladder (OAB) in whom previous conservative treatment failed.

Cited by 13 publications

References 24 publications

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Effectiveness and durability of solifenacin versus percutaneous tibial nerve stimulation versus their combination for the treatment of women with overactive bladder syndrome: a randomized controlled study with a follow-up of ten months

Is there any Relationship Between Bladder Trabeculation and Efficacy and Safety of Intravesical Botulinum Toxin A Injection in Refractory Idiopathic Overactive Bladder Women?

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