Efficacy of posterior tibial nerve stimulation in treating the female patients with overactive bladder

Abstract

Objective To investigate the clinical efficacy of posterior tibial nerve stimulation (PT-NS) for female patients with overactive bladder.Methods From Nov 2011 to Jan 2014,212 female patients with overactive bladder (OAB) were enrolled in this study,prospectively.They were randomly divided into three groups.In the PTNS group (n =70),patients received posterior tibial nerve stimulation therapy once a week for 12 weeks.In the M receptor blockers group (n =73),patients received M receptor blockers (Tolterodine Tartrate Tablets 2mg 2 times per day) for 12 weeks.In the combined treatment group (n =69),patients received PTNS combined with M receptor blockers therapy mentioned above for 12 weeks.The patients underwent a physiotherapeutic evaluation before and after the treatment that included the overactive bladder symptom score (OABSS),mean daily voiding episodes,mean daily incontinence episodes,et al.The PTNS group received the second 12 weeks' PTNS treatment,and part of the patients with an initial positive response to 24 weekly PTNS treatments continued the third round of PTNS therapy (once a week for 24 weeks and Once every 2 weeks for the next 24 weeks).Results During the first 12 weeks' treatment,the OABSS scores declined significantly after the treatment,compared to those before treatment,in each group (The M receptor blockers group:6.3±1.6 vs.8.7±1.8; The PTNS group:6.5±1.9 vs.8,8±1.7; The combined treatment group:5.8± 1.6 vs.8.9± 1.9,P＜0.05).The mean daily voiding episodes,mean nocturia episodes,mean daily incontinence episodes,daily urgency episodes and mean vloume per voiding declined significantly after treatment in each group (P＜0.05).There was no significantly difference in OABSS scores between PTNS group and M receptor blockers group after the treatment (P＞0.05).All recorded items declined significantly in the combined treatment group compared with the other two groups (P＜0.05).In the PTNS group,the OABSS felt from 6.5±1.9 to 6.1±1.9 (P＜0.05) at the end of the second 12 weeks' PTNS treatment.4 patients lost to follow-up in the first 12 weeks' PTNS treatment,4 patients dropped out the the second 12 weeks' PTNS treatment.After the second round treatment,43 patients showed good response to the PTNS treatment.The overall response rate was 69.4％ (43/62).Among them,22 patients continued the third round of PTNS therapy (once a week for 24 weeks and once every 2 weeks for the next 24 weeks).The OABSS scores were 6.4±2.1,6.5±2.2 after 24 and 48 weeks,respectively.Those results were similar to those in the first round treatment (6.4± 1.6,P ＞ 0.05).Conclusions PTNS provides good therapeutic effect for female primary ovcractive bladder.And the combination therapy provided significantly better outcomes than mono therapy.To those patients with an initial positive response,long-term treatment by using this technique could sustain overactive bladder symptom improvement. Key words: Overactive bladder; Posterior tibial nerve stimulation; M receptor blockers