Percutaneous tibial nerve stimulation for the overactive bladder: A single-arm trial

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-04-17 DOI:10.1111/ajo.13822

Hnin Yee Kyaw, Hannah G. Krause, Judith T.W. Goh

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Abstract

Aims

We hypothesise that PTNS is a safe and effective treatment for OAB. Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide, causing diminished quality of life. Lifestyle modifications, muscarinic receptor antagonist and beta-adrenoreceptor agonist remain the mainstay of treatment but are limited by their efficacy and adverse effects. Access to third-line therapies of intravesical botulinum toxin type A or sacral neuromodulation is limited by their invasive nature. Percutaneous tibial nerve stimulation (PTNS) has emerged as a non-invasive treatment option for OAB.

Methods

This study was a single-arm trial of women requesting third-line treatment for OAB. The primary treatment outcome was patient-reported visual analogue score (VAS) improvement of at least 50%. Secondary outcome measures were Urinary Distress Inventory Short Form (UDI-6) score and two-day bladder diary. Patients also provided feedback on adverse effects encountered.

Results

In the 84 women recruited, initial treatment protocol showed a success rate of 77.2% among those who completed treatment based on VAS, with a statistically significant improvement in mean UDI-6 score of 20.13 (P < 0.01, standard deviation: 12.52). Continued success following tapering protocol of 60.8% and a mean maintenance protocol of 14.2 months was achieved. No adverse effects were reported.

Conclusion

The results from this study are in concordance with previously published literature on the effectiveness and safety of PTNS as a treatment modality for OAB. Further randomised controlled trials to evaluate the optimal treatment protocol are warranted to establish a standardised regime.

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经皮胫神经刺激治疗膀胱过度活动症：单臂试验

目的我们假设 PTNS 是治疗膀胱过度活动症的一种安全有效的方法。据估计，膀胱过度活动症（OAB）影响着全球 11.8% 的女性，导致生活质量下降。改变生活方式、毒蕈碱受体拮抗剂和β-肾上腺素受体激动剂仍是治疗的主要手段，但其疗效和不良反应均受到限制。膀胱内注射 A 型肉毒毒素或骶神经调控的三线疗法因其侵入性而受到限制。经皮胫神经刺激疗法（PTNS）已成为治疗 OAB 的一种非侵入性疗法。主要治疗结果是患者报告的视觉模拟评分（VAS）改善至少50%。次要结果指标为尿压力量表简表（UDI-6）评分和两天膀胱日记。结果在招募的 84 名妇女中，根据视觉模拟评分完成治疗的患者中，初始治疗方案的成功率为 77.2%，UDI-6 平均得分显著提高了 20.13 分（P < 0.01，标准偏差：12.52）。60.8%的患者在减量方案后继续成功治疗，平均维持方案时间为 14.2 个月。结论这项研究的结果与之前发表的有关 PTNS 作为 OAB 治疗方法的有效性和安全性的文献一致。有必要进一步开展随机对照试验，评估最佳治疗方案，以建立标准化的治疗体系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian & New Zealand Journal of Obstetrics & Gynaecology 医学-妇产科学

CiteScore

3.40

自引率

11.80%

发文量

165

审稿时长

4-8 weeks

期刊介绍： The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.