Abstract
Introduction and objectives:Overactive bladder syndrome (OAB) is defined as urinary urgency, with or without urgent urinary incontinence; it is often associated with urinary frequency and nocturia, in the absence of any pathological or metabolic conditions that may cause or mimic OAB. The aim of this study was to evaluate the long-term real-life adherence of transcutaneous tibial nerve stimulation (TTNS) in the treatment of OAB, patient satisfaction of the treatment, and reasons for quitting therapy.Materials and methods:In this single center study, all patients who had a positive effect on percutaneous tibial nerve stimulation (PTNS) and continued to receive home-based treatment with TTNS since 2012 were included for analysis. Patients were retrospectively asked to fill out a questionnaire regarding satisfaction, reasons for quitting, and additional or next line of therapy.Results:We included 42 patients for this study, 81% of these patients were female (n = 34). The median age was 67 years (range 36–86). Most of the patients (64%, n = 27) were diagnosed with OAB wet. The median TTNS treatment persistence was 16 months (range 1–112 months). Reasons and percentages for stopping therapy were: 55% stopped treatment due to loss of effect, and 24% stopped because of preferring other type of neuromodulation. The mean satisfaction score (scale 1–10) in patients who continued TTNS was 6.2 (n = 9, SD 1.30) versus 5.4 (n = 29, SD 2.24) for patients who quit therapy. We did not find a statistically significant difference between the two groups (p = 0.174).Conclusion:TTNS, although effective in the short-term, is not effective in the long-term. In combination with a low satisfaction rate among patients, there is a need for improvement in terms of OAB treatment modalities.
Highlights
Introduction and objectivesOveractive bladder syndrome (OAB) is defined as urinary urgency, with or without urgent urinary incontinence; it is often associated with urinary frequency and nocturia, in the absence of any pathological or metabolic conditions that may cause or mimic OAB
Baseline criteria A total of 78 patients underwent percutaneous tibial nerve stimulation (PTNS) followed by transcutaneous tibial nerve stimulation (TTNS) in our University Medical Center
The reasons and numbers for not being included in the study were as follows: 15 patients were lost to follow up, 6 patients had died, and 7 patients were determined to not be physically or mentally competent to fill out the questionnaire
Summary
Introduction and objectivesOveractive bladder syndrome (OAB) is defined as urinary urgency, with or without urgent urinary incontinence; it is often associated with urinary frequency and nocturia, in the absence of any pathological or metabolic conditions that may cause or mimic OAB. The aim of this study was to evaluate the long-term real-life adherence of transcutaneous tibial nerve stimulation (TTNS) in the treatment of OAB, patient satisfaction of the treatment, and reasons for quitting therapy. When drug treatment is unsuccessful, the line of treatment consists of percutaneous tibial nerve stimulation (PTNS) or intravesical Onabotulinum Toxin A injections or sacral nerve stimulation (SNS).[2] Success rates of PTNS were described by Peters et al.[3] in the first shamcontrolled trial for PTNS They described an 43% improvement for urinary urgency, 48% improvement for urinary frequency, 38% improvement for urge incontinence (UUI), and Correspondence to: Manon te Dorsthorst Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, 6500 HB, Netherlands manon.tedorsthorst@ radboudumc.nl. Once PTNS treatment is quitted, patient’s complaints will return; patients will require maintenance therapy.[4]
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