Eficacia de la estimulación percutánea versus transcutánea del nervio tibial posterior en pacientes con vejiga hiperactiva

Abstract

IntroductionThe estimated prevalence of overactive bladder (OAB) ranges from 3 to 43%. The cause is unknown and diagnosis is clinical. Treatment includes behavioral changes, physical therapy, muscarinic receptor antagonists, neuromodulation and botulinum toxin, and surgical procedures. Because of the adverse effects of pharmacologic treatment and its diminished effectiveness over time, therapeutic alternatives such as tibial nerve stimulation have attracted increasing interest.The aim of this study was to evaluate clinical improvement with percutaneous or transcutaneous tibial nerve stimulation in patients with OAB. Materials and methodsA descriptive study was performed through a retrospective review of the medical records of patients with OAB treated with transcutaneous or percutaneous tibial nerve stimulation. We evaluated a 3-day Bladder Diary, the Sandvik Test and the International Consultation on Incontinence-Short Form (ICIQ-SF). ResultsWe included 34 patients with OAB, with a mean age of 64.5 years. All the patients were treated with tibial nerve stimulation (transcutaneous in 61.8% and percutaneous in 38.2%). Nocturnal urinary frequency, the Sandvik test and the ICIQ-SF all showed improvement (P<.001), with no significant statistical difference between the groups. All the patients completed the treatment and all reported satisfaction. DiscussionTibial nerve stimulation is considered a simple, minimally invasive, easy to apply and well tolerated method that has proved to be effective with no marked adverse effects. This treatment improves the patient's quality of life and treatment adherence is adequate. We were unable to demonstrate that percutaneous tibial nerve stimulation was more effective than transcutaneous stimulation.