Comparison of the effects of electrical stimulation and posterior tibial nerve stimulation in the treatment of overactive bladder syndrome.

AIM: To compare the effects of transvaginal electrical stimulation (ES) and posterior tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome (OAB). METHODS: Women applying with symptoms of urgency, frequency, and nocturia with or without incontinence and diagnosed with OAB were divided into an ES or PTNS group. Bladder diary, urodynamics, 1-hour pad test, and King's Health Questionnaire were performed before and after treatment. ES was applied for 20 min, 6-8 weeks with pulses of 10-50 Hz square waves at a 300-µs or 1-ms pulse duration and a maximal output current of 24-60 mA with 5-10 Hz frequency, three times per week. PTNS was applied for 30 min once a week for 12 weeks. RESULTS: Thirty-five patients received ES, 17 patients received PTNS. Pad test, urinary diary, and quality of life parameters after both treatments decreased significantly; the decrease in the ES group was greater. The number of patients who describe themselves as cured was higher in the ES group. CONCLUSION: PTNS and ES are both effective in the treatment of OAB with significant improvement in objective and subjective parameters. Objective results show no significant difference between the two groups; however, the number of patients who describe themselves as cured in the ES group was significantly higher.

The effects of posterior tibial nerve stimulation on refractory overactive bladder syndrome and bladder circulation.

AIM: We aimed to evaluate if posterior tibial nerve stimulation (PTNS) exerts its effects on overactive bladder symptoms through changes in bladder circulation. MATERIALS AND METHODS: Eighteen women who applied to Istanbul Medical Faculty with symptoms of urgency, frequency±urge incontinence and did not respond to anticholinergic treatment and behavioral modification were enrolled in the study. Weekly PTNS in 30-min sessions for 12 weeks was performed. Urogynecologic symptom assessment, 1-h pad test, bladder diary, King's Health Questionnaire (KHQ), and transvaginal Doppler ultrasonography were performed before and after treatment. RESULTS: Ten patients (55.5%) were cured, five (27.8%) improved, and no effect was observed in three (16.7%). No significant change was observed in systolic and diastolic flow rate, pulsatility index, resistive index, systolic/diastolic ratio and average flow rate. Significant decrease in frequency, urgency, urge incontinence, pad test results and increase in fluid intake was observed. There was a significant improvement in physical limitations and sleeping/energy domains of KHQ. No significant change was observed in urodynamics. CONCLUSIONS: PTNS does not have any effect on the bladder circulation despite positive effects on bladder diary, pad test, and quality of life in overactive bladder syndrome.