Comparing tibial nerve stimulation and antimuscarinic agents for the treatment of overactive bladder syndrome.

This study compared the effectiveness and safety of tibial nerve stimulation (TNS) versus antimuscarinic agents for the treatment of patients with overactive bladder (OAB). The study found that TNS was safer and as effective as antimuscarinic agents for the treatment of OAB.

Overactive bladder (OAB) occurs when the bladder muscle is too active. Instead of staying at rest as urine fills the bladder, the bladder contracts. This causes a person to feel a sudden and sometimes overwhelming urge to urinate even when the bladder is not full. OAB syndrome is characterized by symptoms such as experiencing incontinence (involuntary leakage of urine), having a strong urge to urinate, and being woken up at night due to the need to urinate (nocturia). OAB symptoms can have a significant negative effect on the quality of life of patients.

The treatment options for OAB are small surgical procedures, electrical stimulation, and drugs. Tibial nerve stimulation (TNS) is a treatment option for OAB. It aims to use an electric current to stimulate the calf nerves (tibial nerves) responsible for bladder control. Treatments for OAB can also include antimuscarinic agents such as tolterodine (Detrol), oxybutynin (Ditropan), and solifenacin (Vesicare). Antimuscarinic agents control nerve impulses to the bladder. However, how TNS compares in terms of safety and effectiveness to antimuscarinic agents for the treatment of patients with OAB is still unknown.

This study analyzed 8 other studies and involved 420 patients with OAB. Patients were treated with either TNS or antimuscarinic drugs.

TNS was similarly effective as antimuscarinic agents in reducing the number of urinations per day, nocturia urine leakage, and voided volume.

Patients treated with TNS had significantly fewer side effects and less stopping of treatment compared to antimuscarinic agents.

This study concluded that TNS was safer and as effective as antimuscarinic agents for the treatment of OAB.

The sample size was very small. In some of the studies, the patients knew which treatment they were getting. This might have influenced the results. The dosage, variety, frequency, duration, and the cycle of TNS and antimuscarinic agents were different in different studies. Larger studies with a longer follow-up are necessary to evaluate the effectiveness of TNS and antimuscarinic agents.