Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

Schneider, Marc P.; Gross, Tobias; Bachmann, Lucas M.; Blok, Bertil; Castro-Díaz, David; Popolo, Giulio Del; Groen, Jan; Hamid, Rizwan; Karsenty, G.; Pannek, Jürgen; Hoen, Lisette A. ’t; Kessler, Thomas M.

doi:10.1016/j.eururo.2015.07.001

Cited by 88 publications

(81 citation statements)

References 31 publications

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“…There is grade A evidence that electrical stimulation of the tibial nerve by inserting a 34 gauge needle percutaneous tibial nerve stimulation [PTNS] is an effective and safe treatment for idiopathic OAB and the suggestion that this may also be the case for neurogenic lower urinary tract dysfunction is under investigation . PTNS was first introduced in 1999 and has been routinely available for a number of years, receiving FDA approval in 2000 for office based treatment of OAB and approval from NICE in 2006 .…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of transcutaneous tibial nerve stimulation (TTNS) for adults with overactive bladder syndrome: A systematic review

Booth

Connelly

Dickson

et al. 2017

Neurourology and Urodynamics

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Limited evidence is provided that TTNS is an effective, safe intervention for idiopathic OAB in adults and may be of benefit in those with neurogenic OAB. Further studies are essential to confirm these results as well as to determine efficacy and associated costs for specific patient groups, most effective stimulation dosage, duration of effect, and stimulation regimes for longer-term maintenance.

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Section: Introductionmentioning

confidence: 99%

“…Systematic reviews of effectiveness of PTNS alone and general tibial nerve stimulation (including PTNS and TTNS), for OAB and urinary dysfunction and for neurogenic lower urinary tract dysfunction have been published. However, there is no systematic review of the evidence in relation to TTNS alone.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of transcutaneous tibial nerve stimulation (TTNS) for adults with overactive bladder syndrome: A systematic review

Booth

Connelly

Dickson

et al. 2017

Neurourology and Urodynamics

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“…Electrical stimulation (also known as neuromodulation) of the sacral, pudendal, and tibial nerves has been shown to effectively inhibit detrusor contractions caused by NDO . This occurs through modulation of both residual supra‐sacral and segmental reflex pathways during storage and voiding phases of the micturition cycle . The neuromodulation can be given continuously, or conditionally only when NDO occurs.…”

Section: Introductionmentioning

confidence: 99%

Conditional neuromodulation of neurogenic detrusor overactivity using transrectal stimulation in patients with spinal cord injury: A proof of principle study

Knight

Edirisinghe

Leaker³

et al. 2017

Neurourology and Urodynamics

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Aims: A proof of principle study of a novel wearable device to control neurogenic detrusor over-activity in eight male spinal cord injured subjects using conditional neuromodulation. Methods: Transrectal stimulation was delivered through the device in response to simultaneously recorded external anal sphincter (EAS) contraction as a marker for neurogenic detrusor overactivity (NDO). The effect of conditional neuromodulation on bladder capacity and maximum detrusor pressure was investigated in addition to reliability of dyssynergic sphincter contraction as a marker for NDO. Results: Conditional neuromodulation through the novel device showed a statistically significant increase in bladder capacity and reduction in maximum detrusor pressure in six male subjects with spinal cord injury (SCI). EAS activity was a reliable surrogate for detection of NDO. Conclusions: It has been shown for the first time that conditional neuromodulation can be delivered and triggered via a single biocompatible device placed in the anal canal. The pudendal nerves lying in Alcock's canal were stimulated through the wall of the anal canal, and the dyssynergic activity of the EAS was used to detect NDO and trigger neuromodulation giving significant increases in bladder capacity and reduction in detrusor pressure in six male subjects with SCI. K E Y W O R D S neurogenic detrusor over-activity, neuromodulation, spinal cord injuryThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.© 2017 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.Abbreviations: AD, autonomic dysreflexia; CN, conditional neuromodulation; DP, detrusor pressure; DSD, detrusor sphincter dyssynergia; EAS, external anal sphincter; EAS EMG, external anal sphincter electromyogram; EMGthresh.min, value of EAS EMG at which CN would be triggered; EUS, external urethral sphincter; iSCI, incomplete spinal cord injury; MCC, maximum cystometric capacity; MDP, maximum detrusor pressure; NDO, neurogenic detrusor overactivity; PPV, positive predictive indicator; SCI, spinal cord injury; T NDO , time at which detrusor pressure exceeded 15 cmH 2 O.John Heesakkers led the peer-review process as the Associate Editor responsible for the paper.Neurourology and Urodynamics. 2018;37:385-393.wileyonlinelibrary.com/journal/nau | 385

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“…Similarly, it is also useful and safer option in a management of neurogenic lower urinary tract dysfunction (Preyer et al, 2015). It is also recommended in the treatment of refractory cases of urinary dysfunction in children (Schneider et al, 2015), in urinary fecal incontinence (Patidar et al), and in the treatment of chronic anal fissures (Lecompte et al, 2015). The procedure proved to have fewer side effects; commonly pain at the site of stimulation.…”

Section: Discussionmentioning

confidence: 99%

The Tibial Nerve and Its Vasculature: An Anatomical Evaluation

Elbarrany

Altaf

2017

Int. J. Morphol.

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SUMMARY:The study has contributed to evaluate the tibial nerve and its vasculature anatomically. Ten preserved cadavers (5 male, 5 female) have been used for this study. Each cadaver was injected with red latex and through incisions the tibial nerve was exposed at the level of bifurcation of sciatic nerve. The tibial nerve in 85 % cadavers was located between middle and lower thirds at upper angle of popliteal fossa; whereas, in 15 % cadavers it was present below the piriformis muscle in gluteal region. The total length of the tibial nerve was at a mean of 65.26±14.42 cm in males and 64.79±67.61 cm in females, without significantly different. Its total diameter was at a mean of 5.51±1.55 mm, with a mean of 4.11±0.88 mm at the popliteal fossa and a mean of 3.24±0.81mm at its termination deep to the flexor retinaculum in male cadavers. In female; the means were 5.11±0.21 mm, 3.97±1.78 mm and 3.14 ± 0.03 mm respectively without significance difference. It was concluded that tibial nerve has sufficient and good blood supply. Moreover, it can be utilized as allogeneic vascularized nerve graft to repair sizable nerves after limb salvage.

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Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

Cited by 88 publications

References 31 publications

The effectiveness of transcutaneous tibial nerve stimulation (TTNS) for adults with overactive bladder syndrome: A systematic review

The effectiveness of transcutaneous tibial nerve stimulation (TTNS) for adults with overactive bladder syndrome: A systematic review

Conditional neuromodulation of neurogenic detrusor overactivity using transrectal stimulation in patients with spinal cord injury: A proof of principle study

The Tibial Nerve and Its Vasculature: An Anatomical Evaluation

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