Efficacy of posterior tibial nerve stimulation (PTNS) on overactive bladder in older adults

Abstract

Introduction

The main objective of this retrospective study is to determine the efficacy of transcutaneous posterior tibial nerve stimulation (TPTNS) in older patients with overactive bladder (OAB) syndrome. The secondary objective is to look for predictive factors of efficacy of this treatment.

Methods

All patients aged over 65 years with OAB syndrome for which TPTNS was introduced between 2010 and 2016 in two neuro-urology centers were included. Age, gender, etiology of OAB, urinary symptoms and detrusor overactivity (DO) were retrospectively collected. The main outcome was efficacy of TPTNS (i.e., purchase of the device between 3 and 6 months).

Results

A total of 264 patients were included (mean age 74.1 ± 6.5 years; 63.3% of women), of whom 53% had neurogenic OAB. Urinary incontinence was reported by 83.7% of patients and DO was found on urodynamic studies in 154 patients. The overall efficacy of TPTNS was 45.1%. None of the tested factors were significantly predictive of efficacy, especially age (≥ 75 years, p = 0.62), associated stress urinary incontinence (p = 0.69) and presence of DO (p = 0.60), whether neurogenic or not.

Conclusion

TPTNS is an effective treatment in older patients with OAB syndrome. No predictive factors of efficacy were found, especially age and DO. This treatment seems to be a good alternative to antimuscarinics against overactive bladder in older adults.

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Acknowledgements

Collaborators for the GRAPPPA, Clinical research Group of perineal dysfunctions in older adults: Gérard Amarenco, Audrey Charlanes, Camille Chesnel, Xavier Deffieux, Brigitte Fatton, Xavier Gamé, Rebecca Haddad, Claire Hentzen, Claude Jeandel, Jacques Kerdraon, Pierre Mares, Matthieu Mezzadri, Anne Claire Petit, Benoit Peyronnet, Gilberte Robain, Jean Marc Vetel.

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Correspondence to C. Hentzen.

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Conflict of interest

The authors have no financial or any other kind of personal conflicts with this paper. GRAPPPA (Clinical research Group of perineal dysfunctions in older adults) was funded in 2013 by Pr G. Amarenco.

Ethical approval

This retrospective study was accepted by the local ethics committee. The study protocol and data collection were conducted in accordance with the ethical standards of the national research committee and with the Declaration of Helsinki.

Informed consent

All patients were advised of the research and not opposed to the use of their anonymized data.

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Members of GRAPPPA are listed in the “Acknowledgements”.

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Hentzen, C., Haddad, R., Sheikh Ismaël, S. et al. Efficacy of posterior tibial nerve stimulation (PTNS) on overactive bladder in older adults. Eur Geriatr Med 9, 249–253 (2018). https://doi.org/10.1007/s41999-017-0013-3

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Keywords

  • Overactive bladder
  • Aged
  • Tibial nerve stimulation