Abstract

Case Report

Predictors of positive treatment response to PTNS in women with overactive bladder

Suneetha Rachaneni*, Doyo Enki, Megan Welstand, Thomasin Heggie and Anupreet Dua

Published: 18 January, 2022 | Volume 5 - Issue 1 | Pages: 001-004

Percutaneous tibial nerve stimulation (PTNS) is a non-invasive treatment for overactive bladder (OAB). PTNS involves peripheral neuromodulation that uses electrical stimulation to target the spinal cord roots, mainly S3, which controls bladder function. Neuromodulation is postulated to be the effect of cross-signaling between sympathetic and parasympathetic post ganglionic nerve terminals and synapses, causing alteration of nerve signals involved in the voiding reflex. de Groat, et al. described this neurophysiological process and the neural circuits involved in controlling the lower urinary tract [1]. Stimulation of peripheral nerves and subsequent “cross-talk” at the level of the postganglionic neuroeffector junctions can modulate transmission and facilitate detrusor inhibition [2].

Read Full Article HTML DOI: 10.29328/journal.cjog.1001097 Cite this Article Read Full Article PDF

Keywords:

Posterior tibial nerve stimulation; Women; Predictors of success; Overactive bladder; Urinary incontinence

References

  1. de Groat WC, Griffiths D, Yoshimura N: Neural control of the lower urinary tract. Comprehensive Physiology. 2015; 5: 327-396. PubMed: https://pubmed.ncbi.nlm.nih.gov/25589273/
  2. Hubscher CH, Gupta DS, Brink TS. Convergence and cross talk in urogenital neural circuitries. J Neurophysiol. 2013; 110: 1997-2005. PubMed: https://pubmed.ncbi.nlm.nih.gov/23926033/
  3. Klingler HC, Pycha A, Schmidbauer J, Marberger M. Use of peripheral neuromodulation of the S3 region for treatment of detrusor overactivity: a urodynamic-based study. Urology. 2000; 56: 766-771. PubMed: https://pubmed.ncbi.nlm.nih.gov/11068296/
  4. Vandoninck V, van Balken MR, Finazzi Agrò E, Petta F, Micali F, et al. Percutaneous tibial nerve stimulation in the treatment of overactive bladder: urodynamic data. Neurourol Urodyn. 2003; 22: 227-232. PubMed: https://pubmed.ncbi.nlm.nih.gov/12707873/
  5. Wang M, Jian Z, Ma Y, Jin X, Li H, et al. Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis. Int Urogynecol J. 2020; 31: 2457-2471. PubMed: https://pubmed.ncbi.nlm.nih.gov/32681345/
  6. Del Río-Gonzalez S, Aragon IM, Castillo E, Milla-España F, Galacho A, et al. Percutaneous Tibial Nerve Stimulation Therapy for Overactive Bladder Syndrome: Clinical Effectiveness, Urodynamic, and Durability Evaluation. 2017; 108: 52-58. PubMed: https://pubmed.ncbi.nlm.nih.gov/28687483/
  7. Rostaminia G, Chang C, Pincus JB, Sand PK, Goldberg RP. Predictors of successful percutaneous tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome. Int Urogynecol J. 2019; 30: 1735-1745. PubMed: https://pubmed.ncbi.nlm.nih.gov/30498931/
  8. van Balken MR, Vergunst H, Bemelmans BL. Prognostic factors for successful percutaneous tibial nerve stimulation. Eur Urol. 2006; 49: 360-365. PubMed: https://pubmed.ncbi.nlm.nih.gov/16359781/
  9. Pincus J, Rostaminia G, Chang C, Gafni-Kane A, Goldberg RP. Factors associated with overactive bladder symptom improvement after 1 year of monthly percutaneous tibial nerve stimulation therapy. Neurourol Urodynamics. 2019; 38: 1676-1684. PubMed: https://pubmed.ncbi.nlm.nih.gov/31107570/
  10. Iyer S, Laus K, Rugino A, Botros C, Lozo S, et al. Subjective and objective responses to PTNS and predictors for success: a retrospective cohort study of percutaneous tibial nerve stimulation for overactive bladder. Int Urogynecol J. 2019; 30: 1253-1259. PubMed: https://pubmed.ncbi.nlm.nih.gov/30467763/
  11. Kopcsay KS, Marczak TD, Jeppson PC, Cameron AP, Khavari R, et al. Treatment of refractory overactive bladder with OnabotulinumtoxinA vs PTNS: TROOP trial. Int Urogynecol J. 2022. PubMed: https://pubmed.ncbi.nlm.nih.gov/34993598/

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