You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP48)1 Apr 2020MP48-20 OUTCOMES OF PATIENTS WITH REFRACTORY OAB UNDERGOING PERCUTANEOUS TIBIAL NERVE STIMULATION IN REAL LIFE PRACTICE Wesley J. Smith*, B.S Dayron Rodriguez, M.D Alana L. Christie, B.S, M.S Lauren Sudheimer, PA Maude E. Carmel, M.D Gary E. Lemack, andM.D Philippe E. ZimmernM.D. Wesley J. Smith*Wesley J. Smith* More articles by this author , Dayron RodriguezDayron Rodriguez More articles by this author , Alana L. ChristieAlana L. Christie More articles by this author , Lauren SudheimerLauren Sudheimer More articles by this author , Maude E. CarmelMaude E. Carmel More articles by this author , Gary E. LemackGary E. Lemack More articles by this author , and Philippe E. ZimmernPhilippe E. Zimmern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000903.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Percutaneous tibial nerve stimulation (PTNS) has variable success, ranging from 35%-86%. There is a paucity of data in the literature regarding long-term outcomes after PTNS and prognostic factors for success. We report on a single institution’s experience with PTNS treatments for refractory overactive bladder (OAB). METHODS: Following IRB approval, a retrospective chart review of patients who underwent PTNS treatments for refractory OAB was performed as part of a quality improvement project. Data collected included patient demographics, medical history, surgical history, obstetric history, urinary tract symptoms, OAB treatment, pad usage, number of PTNS treatments, and follow-up evolution. Patients were stratified by their completion of 12 PTNS sessions. PTNS was performed by FPMRS-trained specialists. PTNS success was defined as continuation of maintenance PTNS with no other medical/surgical treatments required for symptom relief. RESULTS: From 2012 to 2019, 80/100 patients completed at least 12 sessions, with 58 females (median age: 73 (range 64-79)) and 22 males (median age: 67 (range 58-77)). Females had a median of 5 years on OAB drugs (range 3-10) and failed a median of 2 drugs (range 2-3), while males had median of 4 years on OAB drugs (range 3-7) and failed a median of 3 drugs (range 2-4). PTNS success was 67% in females and 55% among men. Twenty did not want to continue to 12 sessions due to lack of benefits. Six of 26 were satisfied after 12 sessions without pursuing maintenance (see Table). Of those on maintenance PTNS, 39% decided for another therapy ultimately. On univariate analysis, diabetes was found to be a predictor of PTNS failure among female patients (p=0.023). All other prognostic factors were not significant. Regardless of PTNS ‘success’, there was overall decreased daytime frequency (15 to 8, p<0.001), decreased nocturia (3 to 2, p<0.001), and decreased pad usage (3 to 0, p<0.001). CONCLUSIONS: PTNS has a role in the armamentarium of OAB therapy in both men and women. However, the long-term success rate in real life practice requires maintenance therapy in the subgroup of satisfied patients who have done well with the first 12 PTNS sessions. Despite symptomatic improvement in the majority, alternative therapies are often sought out beyond PTNS. Source of Funding: UT Southwestern Urology Department © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e702-e703 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wesley J. Smith* More articles by this author Dayron Rodriguez More articles by this author Alana L. Christie More articles by this author Lauren Sudheimer More articles by this author Maude E. Carmel More articles by this author Gary E. Lemack More articles by this author Philippe E. Zimmern More articles by this author Expand All Advertisement PDF downloadLoading ...
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