Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178
Abrams P, Andersson KE, Birder L et al (2010) Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 29(1):213–240
McGuire EJ, Zhang SC, Horwinski ER, Lytton B (1983) Treatment of motor and sensory detrusor instability by electric stimulation. J Urol 129:78–79
Groen J, Bosch JL (2001) Neuromodulative techniques in the treatment of the overactive bladder. BJU Int 87:723–731
Stoller M (1999) Afferent nerve stimulation for pelvic floor dysfunction. Eur Urol 35:16
Govier FE, Litwiller S, Nitti V, Kreder KJ Jr, Rosenblatt P (2001) Percutaneous afferent neuromodulation for the refractory overactive bladder: results of a multicenter study. J Urol 165:1193–1198
Aslan E, Komurcu N, Beji NK, Yalcin O (2008) Bladder training and Kegel exercises for women with urinary complaints living in a rest home. Gerontology 54:224–231
Tsai E-M, Yang C-H, Chen H-S, Wu C-H, Lee J-N (2001) Bladder neck circulation by Doppler ultrasonography in postmenopausal women with urinary stress incontinence. Obstet Gynecol 98(1):52–56
Dmochowski RR, Newman DK (2007) Impact of overactive bladder on women in the United States: results of a national survey. Curr Med Res Opin 23:65
Henderson E, Drake M (2010) Overactive bladder. Maturitas 66:257–262
Vandoninck V, Van Balken MR, Agro EF et al (2002) Posterior tibial nerve stimulation in the treatment of urge incontinence. Neurourol Urodyn 22:17
Amarenco G et al (2003) Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder. J Urol 169(6):2210–2215
Yang JM, Yang SH, Huang WC (2006) Functional correlates of Doppler flow study of the female urethral vasculature. Ultrasound Obstet Gynecol 28:96–102
Siracusano S, Bertolotto M, D’Aloia G, Silvestre G, Stener S (2001) Color Doppler ultrasonography of female urethral vascularization in normal young volunteers: a preliminary report. BJU Int 88:378–381
Mitterberger M, Pallwein L, Gradl J, Frauscher F, Neuwirt H, Leunhartsberger N, Strasser H, Bartsch G, Pinggera GM (2007) Persistent detrusor overactivity after transurethral resection of the prostate is associated with reduced perfusion of the urinary bladder. BJU Int 99(4):831–835
van Balken MR, Vandoninck V, Gisolf KW, Vergunst H, Kiemeney LA, Debruyne FM, Bemelmans BL (2001) Posterior tibial nerve stimulation as neuromodulative treatment of lower urinary tract dysfunction. J Urol 166:914
Peters KM, Killinger KA, Ibrahim IA, Villalba PS (2008) The relationship between subjective and objective assessments of sacral neuromodulation effectiveness in patients with urgency-frequency. Neurourol Urodyn 27:775
Vandoninck V, van Balken MR, Finazzi Agrò E, Heesakkers JP, Debruyne FM, Kiemeney LA, Bemelmans BL (2004) Posterior tibial nerve stimulation in the treatment of voiding dysfunction: urodynamic data. Neurourol Urodyn 23:246
Acknowledgments
This work was supported by Scientific Research Projects Coordination Unit of Istanbul University. We would like to thank for their support.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Onal, M., Ugurlucan, F.G. & Yalcin, O. The effects of posterior tibial nerve stimulation on refractory overactive bladder syndrome and bladder circulation. Arch Gynecol Obstet 286, 1453–1457 (2012). https://doi.org/10.1007/s00404-012-2464-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-012-2464-6