Tibial nerve stimulation improves urinary symptoms in patients with Parkinson´s disease

This study investigated the effectiveness of percutaneous tibial nerve stimulation (PTNS) treatment in patients with Parkinson's disease (PD) and lower urinary tract symptoms (LUTS). Researchers suggested that PTNS is associated with improved outcomes in these patients.

PD is a chronic disease that affects over 10 million people worldwide. It affects brain cells which control body functions. These cells lose their abilities causing symptoms such as tremors or urinary symptoms (LUTS). LUTS include urinary urgency and nocturia (waking up at night to urinate) which affect 50% of patients with PD. LUTS complicate many daily life activities and affect the quality of life.

LUTS are usually caused by an overactive blader muscle. Treatments such as anticholinergic drugs that control nerve impulses to the bladder are of limited effectiveness and might cause additional side effects. The same effects are observed for botulinum toxin injections that block nerve function or surgery. 

PTNS is another treatment option for LUTS. It involves stimulating the tibial nerve (nerve at the back of the leg) through electrical impulses. During the procedure, a needle is inserted in the ankle. Impulses are sent through the needle to the sacral nerve that controls bladder activity. Prior studies suggested that PTNS improves symptoms of overactive bladder for 12 and 24 months. However, the effectiveness of PTNS in patients with PD and LUTS is still unknown.

This study included information about 76 patients with PD and LUTS. All participants received PTNS for 12 weeks. This was followed by PTNS sessions at 14-day intervals for 3 months, 21-day intervals for 3 months, and 28-day intervals for 24 months. The main outcomes measured were urinary symptoms before and after treatment.

Daytime urinary frequency decreased by 4.6 voids daily. Urge incontinence (urine leakage) decreased by 4.2 episodes daily and urgency episodes decreased by 6.2 episodes daily. Nocturia decreased by 2.4 voids per night and voided volume also improved.

Symptom severity and quality of life also significantly improved at 3, 6, 9, 12, and 24 months.

This study concluded that PTNS is associated with improved urinary symptoms and quality of life in patients with PD and LUTS. 

This study had a small number of participants and did not have a comparison group.