Effects Of Posterior Tibial Nerve Stimulation Research Articles

Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review.

Fecal incontinence is a condition that carries high social stigmatization and a determining factor in the quality of life of the person who suffers from it. Its etiology is multifactorial and treatment includes surgical and conservative measures, including stimulation of the posterior tibial nerve. The aim of this review is to determine whether posterior tibial nerve stimulation (PTNS) is more effective than other treatments in reducing episodes of fecal incontinence in adults. A systematic review of randomized clinical trials that analyzed different approaches and comparisons with other treatments in adults without neurological or metabolic diseases was carried out, analyzing, fundamentally, the reduction of episodes of fecal incontinence. In general, a reduction in fecal incontinence episodes is observed in the experimental groups compared with the control groups, although these differences are not significant in most studies. The results regarding the effectiveness of PTNS in reducing episodes of fecal incontinence compared to other treatments are not entirely conclusive, although benefits are observed regarding the stimulation of sacral roots. More well-designed studies with a long-term follow-up of the results are needed so that the recommendation of this treatment can be generalized.

Posterior Tibial Nerve Stimulation in Children with Lower Urinary Tract Dysfunction: A Mixed-Methods Analysis of Experiences, Quality of Life and Treatment Effect.

Background: Posterior tibial nerve stimulation (PTNS) is one of the treatment modalities for children with therapy-refractory lower urinary tract dysfunction (LUTD). This study used a mixed-methods analysis to gain insight into the experiences of children treated with PTNS and their parents, the effect of treatment on quality of life (QOL) and the effect of PTNS on urinary symptoms. Methods: Quantitative outcomes were assessed through a single-centre retrospective chart analysis of all children treated with PTNS in a group setting between 2016–2021. Voiding parameters and QOL scores before and after treatment were compared. Qualitative outcomes were assessed by an explorative study involving semi-structured interviews transcribed verbatim and inductively analysed using the constant-comparative method. Results: The data of 101 children treated with PTNS were analysed. Overall improvement of LUTD was seen in 42% and complete resolution in 10%. Average and maximum voided volumes significantly increased. QOL improved in both parents and children independent of the actual effect on urinary symptoms. Interviews revealed PTNS to be well-tolerated. Facilitating PTNS in a group setting led to feelings of recognition in both children and parents. Conclusions: PTNS is a good treatment in children with therapy-refractory LUTD and provides valuable opportunities for peer support if given in a group setting.

Posterior tibial nerve stimulation for the treatment of voiding dysfunction 8 years after radical hysterectomy

Lower urinary tract storage and voiding dysfunction are known to occur after radical hysterectomy [1]. Up to 50 % of patients who undergo radical hysterectomy experience at least one urinary tract symptom over a variable period of time [2]. This is probably due to a decrease in musculo-elastic properties of the bladder wall caused by surgical injury and partial damage to the autonomic innervation of the bladder [3]. Lower urinary tract rehabilitation may be offered to these patients including pelvic floor training, behavioral modification, electrical stimulation, and clean intermittent self-catheterization [4]. In the last years, posterior tibial nerve stimulation (PTNS) has become an alternative treatment for voiding dysfunction before proceeding towards more invasive surgical procedures. Van Balken et al. [5] and Vandonick et al. [6] were the first to report the benefit of PTNS in patients with idiopathic nonobstructive voiding dysfunction. However, the literature lacks studies evaluating the effect of PTNS on chronic voiding dysfunction secondary to radical hysterectomy. Here, we report a case that suffered from chronic voiding dysfunction and urinary incontinence for 8 years after radical hysterectomy and treated with PTNS.