Subjective and objective responses to PTNS and predictors for success: a retrospective cohort study of percutaneous tibial nerve stimulation for overactive bladder

Iyer, Shilpa; Laus, Katharina; Rugino, Angela; Botros, Carolyn; Lozo, Svjetlana; Botros, Sylvia M.; Goldberg, Roger P.; Tomezsko, Janet; Gafni-Kane, Adam; Wroblewski, Kristen; Sand, Peter K.

doi:10.1007/s00192-018-3822-0

Cited by 22 publications

(16 citation statements)

References 12 publications

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“…Iyer et al (2018) [21] retrospectively reviewed 183 patients with refractory OAB over a 9-year period who received 30min sessions of PTNS for 12 weeks. There was a statistically significant improvement in urinary frequency, nocturia and urge incontinence episodes in the PTNS group, with the effect seen by week 10 of treatment; 61.5% of participants selfreported > 50% improvement in symptoms with the number of PTNS sessions increasing the odds of subjective success.…”

Section: Ptns Compared With Transvaginal Stimulations and Pelvic Floomentioning

confidence: 99%

Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy

et al. 2019

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The ideal treatment for overactive bladder is still elusive. In those where medication fails to improve symptoms options include invasive treatments such as botulinum toxin-A, sacral neural stimulation or posterior tibial nerve stimulation. Scientific professional society guidelines advise percutaneous posterior tibial nerve stimulation as a third line treatment option only after multidisciplinary team review as well as failure of both conservative and pharmacological management. The aim of this article is to review all techniques for tibial nerve stimulation and their efficacy.

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Section: Ptns Compared With Transvaginal Stimulations and Pelvic Floomentioning

confidence: 99%

Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy

et al. 2019

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“…PTNS is an effective treatment in patients with overactive bladder (OAB) [9]. However, evidence regarding whether TENS is also an effective treatment option in patients with OAB is limited [10,11].…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous Electrical Nerve Stimulation and Percutaneous Tibial Nerve Stimulation to Treat Idiopathic Nonobstructive Urinary Retention: A Systematic Review

Coolen

Groen

Scheepe

et al. 2021

European Urology Focus

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Context: Transcutaneous electrical nerve stimulation (TENS) and percutaneous tibial nerve stimulation (PTNS) provide minimally invasive ways to treat idiopathic nonobstructive urinary retention (NOUR). Objective: To assess the efficacy of TENS and PTNS for treating idiopathic NOUR. Evidence acquisition: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Embase, Medline, Web of Science Core Collection, and the Cochrane CENTRAL register of trials were searched for all relevant publications until April 2020. Evidence synthesis: A total of 3307 records were screened based on the title and abstract. Eight studies met the inclusion criteria and none of the exclusion criteria. Five studies, all from the same group, reported the efficacy of PTNS and two that of TENS in adults with idiopathic NOUR. One study reported the efficacy of TENS in children with idiopathic NOUR. Objective success was defined as a 50% decrease in the number of catheterizations per 24 h or in the total catheterized volume in 24 h. The objective success rate of PTNS ranged from 25% to 41%. Subjective success was defined as the patient's request for continued chronic treatment with PTNS, and ranged from 46.7% to 59%. Eighty percent of women who underwent transvaginal stimulation reported an improvement such as a stronger stream when voiding. TENS in children reduced postvoid residual and urinary tract infections. Conclusions: The efficacy of TENS and PTNS in the treatment of idiopathic NOUR is limited and should be verified in larger randomized studies before application in clinical practice. Patient summary: The outcomes of transcutaneous electrical nerve stimulation and percutaneous tibial nerve stimulation for the treatment of urinary retention of unknown origin were reviewed. Whether these treatments are superior to other treatments could not be established.

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“…To improve efficacy, providers may increase the dose of the drug [2], switch to a different antimuscarinic or try a combination of antimuscarinics to improve the therapeutic efficacy at the expense of producing higher rates of side effects [3].The β3-adrenergic receptor agonist mirabegron is another class of medication that has been in use since 2012 for treatment of OAB with similar clinical efficacy to antimuscarinics. Mirabegron acts through activation of the pre-junctional β3adrenoceptors of the urinary bladder.Treatment of OAB with β3-adrenergic receptor agonists has gradually gained acceptance in recent years as most clinical trials showed a better pharmacological profile and improved patient compliance compared with antimuscarinics [4][5][6].When pharmacotherapy of OAB with either antimuscarinics or β3-adrenergic receptor agonists does not achieve satisfactory results, then the next line of treatment becomes more invasive or inconvenient with increased risks of complications [7,8]. Invasive options include onabotulinumtoxin-A intradetrusor injection, sacral neuromodulation or posterior tibial nerve stimulation [8].…”

mentioning

confidence: 99%

“…Mirabegron acts through activation of the pre-junctional β3adrenoceptors of the urinary bladder.Treatment of OAB with β3-adrenergic receptor agonists has gradually gained acceptance in recent years as most clinical trials showed a better pharmacological profile and improved patient compliance compared with antimuscarinics [4][5][6].When pharmacotherapy of OAB with either antimuscarinics or β3-adrenergic receptor agonists does not achieve satisfactory results, then the next line of treatment becomes more invasive or inconvenient with increased risks of complications [7,8]. Invasive options include onabotulinumtoxin-A intradetrusor injection, sacral neuromodulation or posterior tibial nerve stimulation [8]. In May 2018, the FDA approved combination therapy of a β3-adrenergic agonist and an antimuscarininc, solifenacin, as another pharmacological treatment option for OAB [9].…”

mentioning

confidence: 99%

“…When pharmacotherapy of OAB with either antimuscarinics or β3-adrenergic receptor agonists does not achieve satisfactory results, then the next line of treatment becomes more invasive or inconvenient with increased risks of complications [7,8]. Invasive options include onabotulinumtoxin-A intradetrusor injection, sacral neuromodulation or posterior tibial nerve stimulation [8]. In May 2018, the FDA approved combination therapy of a β3-adrenergic agonist and an antimuscarininc, solifenacin, as another pharmacological treatment option for OAB [9].…”

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confidence: 99%

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Combination pharmacotherapy for the treatment of the overactive bladder syndrome: a new solution for an old problem?

El-Zawahry

Rizk

2019

Int Urogynecol J

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Overactive bladder syndrome (OAB) is a chronic urological condition that affects almost 20% of the population with a significant adverse impact on the quality of life. OAB may also have serious health consequences including mortality secondary to the increased risk of depression, falls and fractures. Thus far, the use of antimuscarinic therapy in OAB patients has been disappointing with reported compliance rates between 17%-35% after 2 years. Critical appraisal of novel pharmacological modalities for treatment of OAB, therefore, remains a research priority.Successful treatment of OAB requires proper clinical evaluation. In addition, patient counseling is important as compliance with treatment is instrumental in improving therapeutic efficacy. The treatment algorithm for OAB is a stepwise approach beginning with conservative measures [1] and ending with more invasive procedures.Pharmacotherapy is frequently resorted to after the failure of conservative therapy or initially in appropriately selected patients. Antimuscarinics are commonly used; however, discontinuation rates are very high because of bothersome side effects or inadequate clinical response. To improve efficacy, providers may increase the dose of the drug [2], switch to a different antimuscarinic or try a combination of antimuscarinics to improve the therapeutic efficacy at the expense of producing higher rates of side effects [3].The β3-adrenergic receptor agonist mirabegron is another class of medication that has been in use since 2012 for treatment of OAB with similar clinical efficacy to antimuscarinics. Mirabegron acts through activation of the pre-junctional β3adrenoceptors of the urinary bladder.Treatment of OAB with β3-adrenergic receptor agonists has gradually gained acceptance in recent years as most clinical trials showed a better pharmacological profile and improved patient compliance compared with antimuscarinics [4][5][6].When pharmacotherapy of OAB with either antimuscarinics or β3-adrenergic receptor agonists does not achieve satisfactory results, then the next line of treatment becomes more invasive or inconvenient with increased risks of complications [7,8]. Invasive options include onabotulinumtoxin-A intradetrusor injection, sacral neuromodulation or posterior tibial nerve stimulation [8]. In May 2018, the FDA approved combination therapy of a β3-adrenergic agonist and an antimuscarininc, solifenacin, as another pharmacological treatment option for OAB [9]. This may offer an additional promising non-invasive therapeutic management step between single-agent pharmacotherapy and more invasive approaches for the treatment for patients with OAB.The FDA decision was based on three seminal, multicenter and prospective randomized, double-blind, placebocontrolled trials, the SYMPHONY trial [10], BESIDE trial [11] and SYNERGY trial [12]. These demonstrated a significant improvement in urgency, urgency incontinence and other storage symptoms in the combination therapy arm compared with placebo or monotherapy. In all three studies, combination ...

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Subjective and objective responses to PTNS and predictors for success: a retrospective cohort study of percutaneous tibial nerve stimulation for overactive bladder

Cited by 22 publications

References 12 publications

Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy

Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy

Transcutaneous Electrical Nerve Stimulation and Percutaneous Tibial Nerve Stimulation to Treat Idiopathic Nonobstructive Urinary Retention: A Systematic Review

Combination pharmacotherapy for the treatment of the overactive bladder syndrome: a new solution for an old problem?

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