Transcutaneous tibial nerve stimulation: 2years follow-up outcomes in the management of anticholinergic refractory overactive bladder.

Abstract

To evaluate long-term use, efficacy and tolerability of transcutaneous tibial nerve stimulation (TTNS) in the treatment of refractory overactive bladder (OAB). We performed a prospective observational study and included all patients treated in a single center for OAB persisting after first-line anticholinergic treatment, with ≥ 24months follow-up. The protocol consisted of daily stimulation at home. The primary outcome was treatment persistence. Amelioration was defined as an improvement in urinary symptom profile (USP) score. We assessed 84 consecutive patients. After a mean follow-up of 39.3months and a mean treatment use of 8.3months, almost two-thirds of patients (71.8%) had discontinued TTNS. Treatment continuation was > 12months for 28 patients (33.3%) and > 18months for 16 patients (19%). TTNS was successful following 3months of treatment in 60 (71%) patients. Mean USP score stayed significantly lower than baseline until 12months of treatment, but was not significant anymore after 18months. Discontinuation therapy reasons were a lack of sufficient symptom relief for 59 (70%) patients, compliance difficulty for 5 (6%) patients and becoming asymptomatic for 6 (8%) patients. No serious adverse events occurred. The present study confirms the utility of TTNS as a treatment option for patients with resistant OAB. In the long-term use, few patients continued with therapy, mostly because of a decreased effectiveness with time.