The management of overactive bladder

Tubaro, Andrea; Puccini, Federica; Nunzio, Cosimo De

doi:10.1097/mou.0000000000000180

Cited by 28 publications

(8 citation statements)

References 26 publications

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“…In patients refractory to pharmacological treatment intravesical injection of botulinum toxin may be offered, although this requires frequent re-injection for continued benefit. There is also a risk of urinary tract infection and high residual volume, which may require patients to perform self-catheterization (Gupta et al, 2015 ; Tubaro et al, 2015 ; Olivera et al, 2016 ; Truzzi et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

“…Percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS) have both been adopted as clinical procedures for urge incontinence (Yamanishi et al, 2015 ). However, PTNS requires a frequent schedule of re-application whereas high levels of re-intervention are required with SNS and pain is a frequent side effect (Gupta et al, 2015 ; Tubaro et al, 2015 ; Olivera et al, 2016 ; Truzzi et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

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High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats

Crook

Lovick

2017

Front. Physiol.

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Urge Urinary Incontinence: “a sudden and uncontrollable desire to void which is impossible to defer” is extremely common and considered the most bothersome of lower urinary tract conditions. Current treatments rely on pharmacological, neuromodulatory, and neurotoxicological approaches to manage the disorder, by reducing the excitability of the bladder muscle. However, some patients remain refractory to treatment. An alternative approach would be to temporarily suppress activity of the micturition control circuitry at the time of need i.e., urgency. In this study we investigated, in a rat model, the utility of high frequency pelvic nerve stimulation to produce a rapid onset, reversible suppression of voiding. In urethane-anesthetized rats periodic voiding was induced by continuous infusion of saline into the bladder whilst recording bladder pressure and electrical activity from the external urethral sphincter (EUS). High frequency (1–3 kHz), sinusoidal pelvic nerve stimulation initiated at the onset of the sharp rise in bladder pressure signaling an imminent void aborted the detrusor contraction. Urine output was suppressed and tone in the EUS increased. Stimulating the right or left nerve was equally effective. The effect was rapid in onset, reversible, and reproducible and evoked only minimal “off target” side effects on blood pressure, heart rate, respiration, uterine pressure, or rectal pressure. Transient contraction of abdominal wall was observed in some animals. Stimulation applied during the filling phase evoked a small, transient rise in bladder pressure and increased tonic activity in the EUS, but no urine output. Suppression of micturition persisted after section of the contralateral pelvic nerve or after ligation of the nerve distal to the electrode cuff on the ipsilateral side. We conclude that high frequency pelvic nerve stimulation initiated at the onset of an imminent void provides a potential means to control urinary continence.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats

Crook

Lovick

2017

Front. Physiol.

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“…This therapy requires the injection of the toxin into the muscle of the bladder with the effects lasting from 6–8 months 18,19. Studies have shown that onabotulinum toxin A is highly effective in treating OAB symptoms, comparable to other third-line treatments 20. It is important to acknowledge that comparing these therapies is difficult because there is no clear-cut definition of clinical success or improvement and measuring each parameter is done differently for each study.…”

Section: Discussionmentioning

confidence: 99%

<p>New Implantable Tibial Nerve Stimulation Devices: Review of Published Clinical Results in Comparison to Established Neuromodulation Devices</p>

Yamashiro

Riese

2019

RRU

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PurposeThe purpose of this review is to offer an update for medical providers practicing general urology and urogynecology in evolving and new promising technologies for neuromodulation in patients with OAB.Patients and MethodsA focused literature search for the years 2015 through 2019 was conducted on PubMed/Medline for the terms: “new techniques” AND “neuromodulation” AND “tibial nerve stimulation” AND “overactive bladder”. We limited our search to publications in English, for the last five years and with patient follow-up of at least 3 months.ResultsClinical success, safety based on adverse events, and quality of life improvement criteria were evaluated and compared to sacral nerve stimulation (SNS) devices and older, non-implantable percutaneous tibial nerve stimulation (PTNS) treatment devices. Considering the limited number of participants with up to 6 months follow-up data currently available, overall the clinical response rates suggest that the new implantable devices stimulating the tibial nerve have a promising clinical outlook, are less invasive upon implantation than SNS, less expensive, and less of a burden on patients compared to the older non-implantable PTNS devices.ConclusionPracticing urologists should be aware of this new treatment option when counseling their patients regarding treatment for OAB.

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“…Uma revisão sistemática com artigos dos últimos 10 anos, comparando eletroestimulação sacral, NTP e toxina botulínica, demonstrou melhora na qualidade de vida (QV) por meio da eletroestimulação sacral. 17 O estudo não incluiu TMAP, mas afirmou que os resultados da última década mostram que as vantagens da eletroestimulação aumentaram muito em relação ao uso de medicamentos.…”

Section: Discussionunclassified

Tratamento da bexiga hiperativa em mulheres com uso da eletroestimulação do nervo tibial e da eletroestimulação sacral

Duarte

Castiglione

Burti

et al. 2019

Rev. Fac. Ciênc. Méd. Sorocaba

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Objetivo: Avaliar os efeitos da eletroestimulação transcutânea do nervo tibial e da eletroestimulação sacral para o tratamento de mulheres com diagnóstico de síndrome bexiga hiperativa por meio de uma revisão de literatura. Métodos: Busca eletrônica realizada nas bases de dados Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME), Scientific Electronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro) e PubMed para a identificação de artigos científicos publicados no período de janeiro de 2007 a setembro de 2016, utilizando as palavraschave “fisioterapia”, “eletroterapia”, “tratamento”, “eletroestimulação nervosa transcutânea do nervo tibial e da região sacral”, “incontinência urinária mista”, “incontinência urinária de urgência” e “mulheres”. Resultados: Foram achados apenas quatro artigos que relacionavam os tratamentos com a população feminina. Conclusão: Existem poucos estudos sobre a eletroestimulação do nervo tibial posterior e sacral como tratamento para bexiga hiperativa, entretanto os poucos achados, em maior número em eletroestimulação sacral, demonstraram-se eficazes para tratamentos a longo prazo, evidenciando, assim, necessidade de mais pesquisa na área.

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The management of overactive bladder

Abstract: http://links.lww.com/COU/A7.

Cited by 28 publications

References 26 publications

High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats

High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats

<p>New Implantable Tibial Nerve Stimulation Devices: Review of Published Clinical Results in Comparison to Established Neuromodulation Devices</p>

Tratamento da bexiga hiperativa em mulheres com uso da eletroestimulação do nervo tibial e da eletroestimulação sacral

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