[Treatment of idiopathic overactive bladder in women: Transcutaneous tibial nerve stimulation alone versus combined with pelvic floor muscle training]

Prog Urol. 2020 Dec;30(17):1126-1133. doi: 10.1016/j.purol.2020.04.024. Epub 2020 Jul 15.
[Article in French]

Abstract

Background: The treatment of overactive bladder syndrome (OABS) by percutaneous pelvic nerve stimulation (PTNS) is usually recommended as a third line treatment. The purpose of this work was to compare PTNS alone on idiopathic OABS in women against a treatment combining PTNS and pelvic floor muscle training (PFMT).

Methods: This was a retrospective comparative study of 58 patients, followed at the urodynamic unit. Thirty patients received PTNS alone and 28 PTNS+pelvic floor rehabilitation. The main instrument used to measure the outcomes was the voiding diary.

Results: The average age of our patients was 55.2 years. In the PTNS group, there was a significant improvement in daily micturitions (6 after PTNS vs. 10 before, P<0.001), nocturia (1.08 after PTNS vs. 1.75 before, P=0.003), urgency (7 daily before PTNS vs. 11 before (P<0.001) and maximum voided volume (378mL after PTNS vs. 306mL before, P=0.004). The Ditrovie score and USP scores showed a significant decrease. In the PTNS+PFMT group, a significant improvement was noted for the criteria: daily frequency episodes (5.7 after PTNS+PFMT vs. 7.56 before, P<0.001), nocturia (1.4 after PTNS+PFMT vs. 2.3 before, P=0.001), and daily urgency episodes (7 after PTNS+PFMT vs. 9 before, P<0.01). The OAB and SUI USP scores and the Ditrovie score decreased significantly (USP SUI score: 1.2 after PTNS+PFMT vs. 3.4 before (P<0.001) ; USP OAB score: 5.2 after PTNS+PFMT vs. 10.4 before, P<0.001). The comparison of the two groups (PTNS vs. PTNS+PFMT) did not show any significant difference in the voiding dairy outcomes and in the subjective scores outcomes (USP and Ditrovie).

Conclusion: No significant difference was observed concerning outcomes following PTNS alone and combined PTNS and PFMT in women presenting OABS.

Level of evidence: 3.

Keywords: Electric stimulation therapy; Femme; Hyperactivité vésicale; Urinary overactive bladder; Women; Électrothérapie.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Exercise Therapy*
  • Female
  • Humans
  • Middle Aged
  • Pelvic Floor
  • Retrospective Studies
  • Tibial Nerve
  • Transcutaneous Electric Nerve Stimulation*
  • Urinary Bladder, Overactive / therapy*
  • Young Adult