Aim of this pilot study was to assess the feasibility of a home-based transcutaneous tibial nerve stimulation (TTNS) protocol in patients responding to percutaneous tibial nerve stimulation (PTNS).
Materials and methods
16 overactive bladder syndrome (OAB) patients, responding to PTNS, were included. Patients performed a flexible home protocol of TTNS. Satisfied patients were considered “subjective responders”; patients not showing a ≥10% increase of urgency/urgency incontinence episodes/day were considered “objective responders”.
Results
14/16 patients were followed up for a mean of 19.7 months. All patients were considered subjective responders; 13 were considered objective responders. The mean number of stimulations/week was 1.6 (1–3).
Conclusions
After this pilot study, it is possible to conclude that home-based TTNS is feasible. Nevertheless, further randomized trials are needed before drawing any conclusions.
AbramsP., CardozoL., FallM., GriffithsD., RosierP., UlmstenU., Van KerrebroeckP., VictorA., WeinA; The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society.Urology2003; 61(1): 37–49.
2.
MilsomI., AbramsP., CardozoL., RobertsR.G., ThuroffJ., WeinA.J.How widespread are the symptoms of an overactive bladder and how are they managed? A popolation-based study.BJU Int.2001; 87(9): 760–766.
3.
InwinD.E., AbramsP., MilsonI., KoppZ., ReillyK.Understanding the elements of overactive bladder: questions raided by the EPIC study.BJU Int.2008; 101(11): 1381–1387.
4.
McGuireE.J., ZhangS.C., HorwinskiE.R., LyttonB: Treatment of motor and sensory detrusor instability by electrical stimulation.J Urol1983; 129(1): 78–9.
5.
BirderL., RoppoloJ., EricksonV., De GroatW.Increased c-fos expression in spina lumbosacral projection neurons and pre-ganglionic neurons after irritation of the lower urinary tract in the rat.Brain Res1999; 834: 55–65.
KlinglerH.C., PychaA., SchmidbauerJ., MarbergerM.: Use of peripheral neuromodulation of the S3 region for treatment of detrusor overactivity: a urodynamic-based study.Urology.2000 Nov 1; 56(5): 766–71. Med Devices 2005; 2: 253-258.
8.
GovierF.E., LitwillerS., NittiV., KrederK.J.Jr., RosenblattP.: Percutaneous afferent neuromodulation for the refractory overactive bladder: results of a multicenter study.J Urol.2001 Apr; 165(4): 1193–8.
9.
van BalkenM.R., VandoninckV., GisolfK.W., VergunstH., KiemeneyL.A., DebruyneF.M., BemelmansBL.: Posterior tibial nerve stimulation as neuromodulative treatment of lower urinary tract dysfunction.J Urol.2001 Sep; 166(3): 914–8.
10.
VandoninckV., Van BalkenM.R., FinazziAgrò E., PettaF., CaltagironeC., HeesakkersJ.P., KiemeneyL.A., DebruyneF.M., BemelmansB.L.Posterior tibial nerve stimulation in the treatment of urge incontinence.Neurourol Urodyn.2003; 22(1): 17–23.
11.
KennethM., Peters DonnaJ.Randomized trial of percutaneous tibial nerve stimulation versus sham efficacy in the treatment of overactive bladder syndrome: result from the sumit trial.J Urol.2010 Apr; 183(4): 1438–43.
12.
FinazziAgrò E., PettaF., SciobicaF., PasqualettiP., MuscoS., BoveP.Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, duble-blind, placebo controlled trial.Urol.2010 Nov; 184(5): 2001–6.
13.
Van der PalF., van BalkenM.R., HeesakkersJ.P.Implant-driver tibial nerve stimulation in the treatment of refractory overactìve baldder syndrome: 12-month follow-up.Neuromodulation2006; 9: 163–171.
14.
MacDiarmidScott A, PetersKenneh M, ShobeiriAbbas. Long-Term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder.J Urol.2010 Jan; 183(1): 234–40.
15.
BurtonC., & MaurerD.D. (1974). Pain suppression by transcutaneous electrical nerve stimulation.IEEE Transactions on Biomedical Engineering, 21, 81–88.
16.
TENS in Chronic Prostatitis and Pelvic Pain Syndrome, International Braz J Urol Vol. 34(6): 708–714, November -December, 2008.
17.
De SèzeM., RaibautP., GalienP., Even-SchneiderA., DenysP., BonniaudV., GamèX., AmarencoG.Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study.Neurourol Urod.2011; 30(3): 306–11.
18.
SchreinerL., dos SantosT.G., KnorstM.R., da Silva FilhoI.G.Randomized trial of transcutaneous tibial nerve stimulation to treat urge urinary incontinence in older women.Int Urogynecol J.2010 Sep; 21(9): 1065–70.
