Skip to main content

Advertisement

SpringerLink
Log in

Predictors of successful percutaneous tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Multiple publications have demonstrated the efficacy of percutaneous tibial nerve stimulation (PTNS) for overactive bladder syndrome (OAB). However, patient characteristics associated with successful treatment have not been well established.

The aim of this study was to identify prognostic factors for successful PTNS treatment.

Methods

This was a retrospective chart review of women who underwent PTNS therapy for OAB between January 2011–Decemeber 2017. Treatment success was defined by subjective improvement according to patient self-report and objective bladder diary parameters including the intervoiding interval, nocturia episodes and urgency urinary incontinence (UUI) episodes per day, before and after PTNS treatment. Baseline symptoms were dichotomized for each symptom based on severity.

Results

One hundred sixty-two women with a mean age of 72.7 ± 11.3 years and BMI of 28.5 ± 7.1 were included in the study. There was a statistically significant improvement in all three OAB symptoms after treatment. Multivariable analysis revealed that a history of depression and anxiety was associated with subjective improvement, whereas decreased subjective improvement was associated with a history of hypertension, prior intravesical onabotulinnumtoxinA injection and sacral neuromodulation. While dichotomizing subjects into two groups defined by < 50% versus ≥ 50% improvement, depression/anxiety, urodynamic volume at first sensation to void and more severe baseline urgency urinary incontinence severity were all significant predictors of subjective improvement.

Conclusions

Among women treated with PTNS for refractory OAB, a history of depression/anxiety and severe baseline urgency urinary incontinence were positive predictors of a successful PTNS outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Haylen BT, Freeman RM, Lee J, Swift SE, Cosson M, Deprest J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related to native tissue female pelvic floor surgery. Int Urogynecol J. 2012;23(5):515–26. https://doi.org/10.1007/s00192-011-1659-x.

    Article  PubMed  Google Scholar 

  2. Choo M-S, Ku JH, Lee JB, Lee DH, Kim JC, Kim H-J, et al. Cross-cultural differences for adapting overactive bladder symptoms: results of an epidemiologic survey in Korea. World J Urol. 2007;25(5):505–11.

    Article  Google Scholar 

  3. Corcos J, Schick E. Prevalence of overactive bladder and incontinence in Canada. Can J Urol. 2004;11(3):2278–84.

    PubMed  Google Scholar 

  4. Coyne KS, Sexton CC, Vats V, Thompson C, Kopp ZS, Milsom I. National community prevalence of overactive bladder in the United States stratified by sex and age. Urology. 2011;77(5):1081–7.

    Article  Google Scholar 

  5. Donaldson M, Thompson JR, Matthews RJ, Dallosso H, McGrother C. The natural history of overactive bladder and stress urinary incontinence in older women in the community: a 3-year prospective cohort study. Neurourol Urodyn. 2006;25(7):709–16.

    Article  CAS  Google Scholar 

  6. Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, et al. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn. 2015;34(3):224–30.

    Article  Google Scholar 

  7. Siegel S, Paszkiewicz E, Kirkpatrick C, Hinkel B, Oleson K. Sacral nerve stimulation in patients with chronic intractable pelvic pain. J Urol. 2001;166(5):1742–5.

    Article  CAS  Google Scholar 

  8. Levin PJ, Wu JM, Kawasaki A, Weidner AC, Amundsen CL. The efficacy of posterior tibial nerve stimulation for the treatment of overactive bladder in women: a systematic review. Int Urogynecol J. 2012;23(11):1591–7.

    Article  Google Scholar 

  9. Peters KM, MacDiarmid SA, Wooldridge LS, Leong FC, Shobeiri SA, Rovner ES, et al. Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol. 2009;182(3):1055–61.

    Article  CAS  Google Scholar 

  10. Van Balken M, Vergunst H, Bemelmans B. Prognostic factors for successful percutaneous tibial nerve stimulation. Eur Urol. 2006;49(2):360–5.

    Article  Google Scholar 

  11. Finazzi Agrò E, Petta F, Bove P, D'Amico A, Germani S, Campagna A, et al. Percutaneous tibial nerve stimulation (PTNS) in the treatment of urge incontinence: a double blind, placebo controlled study. Urodinamica. 2005;15(3):171–2.

    Google Scholar 

  12. Peters K, MacDiarmid S, Wooldridge L, Leong F, Shobeiri S, Rovner E, et al. Neurourol Urodyn. 2009;7:881–2.

    Google Scholar 

  13. Gamble TL, Botros SM, Beaumont JL, Goldberg RP, Miller J-JR, Adeyanju O, et al. Predictors of persistent detrusor overactivity after transvaginal sling procedures. Am J Obstet Gynecol. 2008;199(6):696.e691–7.

    Article  Google Scholar 

  14. Vandoninck V, van Balken MR, Agró EF, Petta F, Caltagirone C, Heesakkers JP, et al. Posterior tibial nerve stimulation in the treatment of urge incontinence. Neurourol Urodyn. 2003;22(1):17–23.

    Article  Google Scholar 

  15. Vandoninck V, van Balken MR, Finazzi Agrò E, Petta F, Micali F, Heesakkers JP, et al. Percutaneous tibial nerve stimulation in the treatment of overactive bladder: urodynamic data. Neurourol Urodyn. 2003;22(3):227–32.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. NorthShore University HealthSystem Research Institute, Evanston, IL, USA

    Ghazaleh Rostaminia & Cecilia Chang

  2. Division of Urogynecology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA

    Joseph B. Pincus, Peter K. Sand & Roger P. Goldberg

Authors
  1. Ghazaleh Rostaminia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cecilia Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph B. Pincus
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter K. Sand
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Roger P. Goldberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ghazaleh Rostaminia.

Ethics declarations

Conflicts of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rostaminia, G., Chang, C., Pincus, J.B. et al. Predictors of successful percutaneous tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome. Int Urogynecol J 30, 1735–1745 (2019). https://doi.org/10.1007/s00192-018-3834-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-018-3834-9

Keywords

Search

Navigation