What factors can cause maintenance Percutaneous Tibial Nerve Stimulation treatment for overactive bladder?

This study looked at the factors affecting patients with overactive bladder (OAB). These factors can cause patients to return for more percutaneous tibial nerve stimulation (PTNS) treatments. It concluded that patients who returned for more PTNS did not improve in all OAB symptoms. 

Overactive Bladder (OAB) is a sudden, frequent urge to urinate. It may result in urge incontinence (inability to hold on to urine). OAB urination is usually eight or more times a day and two or more times at night. OAB can have a negative impact on quality of life. Medications can be taken to calm the muscles and nerves which cause OAB. These medications however, can carry side effects.

Another treatment option for OAB is nerve stimulation. This works by using electricity to stimulate nerves. These nerves affect the muscles of the bladder. Percutaneous nerve stimulation (PNS) involves implanting a stimulating device into the body, on bone. One nerve which may be stimulated is the tibial nerve. 

79 patients with OAB were included in the study. These patients were referred for PTNS. Patients were given PTNS treatment for 12 weeks. Patients symptoms were assessed with questionnaires at week 1 and week 12. An OAB severity questionnaire, lower urinary tract symptoms questionnaire and bladder diary were used. Patient's quality of life was also assessed. If patients felt OAB symptoms return after 2 weeks, they could have more PTNS treatments. At the end of the study, the patients were evaluated and split into groups. Group 1 were patients who did not respond to PTNS. Group 2 were patients who did respond and who did not return for more PTNS after week 12. Group 3 were patients who did respond and who did return for more PTNS after week 12. 

Patients were assessed for differences based on race, age, gender, diagnosis, symptom severity before treatment and bladder diary results. No significant differences were observed between Groups 1, 2 and 3 in these areas. Patients in groups 2 and 3 had significantly improved OAB symptoms after 12 weeks. Patients in group 3 reported improved night time urination and patient satisfaction after further PTNS treatment. Statistical analysis also confirmed night time urination and patient satisfaction were influencing factors in PTNS treatment. 

This study concluded that night time urination and level of patient satisfaction are influencing factors in PTNS treatment. 

The authors note that patients returned for further PTNS treatment at different times. Further treatment times were not standardised. This may affect the study's results. 

If you are interested in learning more about PTNS for OAB, contact your doctor.