Posterior Tibial Nerve Stimulation for Treating Neurologic Bladder in Women: a Randomized Clinical Trial

  • Tahereh Eftekhar Department of Gynecology and Obstetrics, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Nastaran Teimoory Mail Department of Gynecology and Obstetrics, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Elahe Miri Department of Gynecology and Obstetrics, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Abolghasem Nikfallah Brain and Spinal Injury Repair Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Mahsa Naeimi Department of Gynecology and Obstetrics, Imam Hospital,Tehran University of Medical Sciences, Tehran, Iran.
  • Mahsa Ghajarzadeh Brain and Spinal Injury Repair Research Center, Tehran University of Medical Sciences, Tehran Iran.
Keywords:
Overactive bladder (OAB), Posterior tibial nerve stimulation (PTNS), Tolterodine

Abstract

Overactive bladder (OAB) is a disabling disorder. Treatment of cases with OAB includes behavioral, pharmacological, surgical interventions and peripheral electrical stimulation. The goal of this study was to determine effects of posterior tibial nerve stimulation on sexual function and pelvic disorders in women with Overactive bladder (OAB). Fifty women were randomly assigned to PTNS (posterior tibial nerve stimulation) plus tolterodine or tolterodine alone treatment. Tolterodine group received 4 mg tolterodine daily for three months while the other group received this treatment plus percutaneous tibial nerve stimulation for 12 consequence weeks. Two in PTNS group and 8 in the control group withdrew from the study. Age, education level, and occupation status were not significantly different between two groups. Mean total FSFI and its subscales were not significantly different before and after treatment between two groups. Urine leakage associated with a feeling of urgency and loss of stool or gas from the rectum beyond patient's control became significantly different after treatment between two groups. Posterior tibial nerve stimulation could help urinary problems in women with a neurologic bladder.

References

Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Subcommittee of the International Continence Society. Neurourol Urodyn 2002;21(2):167-78.

Beneton C, De Parisot O. The medical treatment of overactive bladder. Neurochirurgie 2003;49(2-3 Pt 2):369-76.

Chughtai B, Levin R, De E. Choice of antimuscarinic agents for overactive bladder in the older patient: focus on darifenacin. Clin Interv Aging 2008;3(3):503-9.

Abrams P, Kelleher C, Kerr LA, et al. Overactive bladder significantly affects quality of life. The Am J Manag Care 2000;6(11 Suppl): S580-90.

Brown JS, Vittinghoff E, Wyman JF, et al. Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 2000;48(7):721-5.

Wagg A, Cohen M. Medical therapy for the overactive bladder in the elderly. Age Ageing 2002;31(4):241-6.

Ulahannan D, Wagg A. The safety and efficacy of tolterodine extended release in the treatment of overactive bladder in the elderly. Clin Interv Aging 2009;4:191-6.

Fall M, Lindström S. Electrical stimulation. A physiologic approach to the treatment of urinary incontinence. Urol Clin North Am 1991;18(2):393-407.

McGuire E, Zhang S, Horwinski E, et al. Treatment of motor and sensory detrusor instability by electrical stimulation. J Urol 1983;129(1):78-9.

Previnaire J, Soler J, Perrigot M, et al. Short-term effect of the pudendal nerve electrical stimulation on detrusor hyperreflexia in spinal cord injury patients: importance of current strength. Paraplegia 1996;34(2):95-9.

Amarenco G, Ismael SS, Even-Schneider A, et al. Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder. J Urol 2003;169(6):2210-5.

Peters KM, Carrico DJ, Wooldridge LS, et al. Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study. J Urol 2013;189(6):2194-201.

Peters KM, MacDiarmid SA, Wooldridge LS, et al. Randomized trial of percutaneous tibial nerve stimulationversus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol 2009;182(3):1055-61.

MacDiarmid SA, Peters KM, Shobeiri SA, et al. Longterm durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol 2010;183(1):234-40.

Tanagho E, Schmidt R. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol 1988;140(6):1331-9.

Yamanishi T, Sakakibara R, Uchiyama T, et al. Comparative study of the effects of magnetic versus electrical stimulation on inhibition of detrusor overactivity. Urology 2000;56(5):777-81.

Vodusek DB, Light JK, Libby JM. Detrusor inhibition induced by stimulation of pudendal nerve afferents. Neurourol Urodyn 1986;5(4):381-9.

How to Cite
1.
Eftekhar T, Teimoory N, Miri E, Nikfallah A, Naeimi M, Ghajarzadeh M. Posterior Tibial Nerve Stimulation for Treating Neurologic Bladder in Women: a Randomized Clinical Trial. Acta Med Iran. 52(11):816-821.
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