NEW YORK (Reuters Health) – Percutaneous tibial nerve stimulation is an effective therapy for overactive bladder symptoms, according to a report in the April issue of The Journal of Urology.

“Neuromodulation is improving the management of voiding dysfunction, and having devices that provide neurostimulation at the tibial nerve or at the sacral nerves should be considered in patients that do not respond or are intolerant to oral medications,” lead author Dr. Kenneth M. Peters from Beaumont Hospital, Royal Oak, Michigan, told Reuters Health by email

Dr. Peters and colleagues compared percutaneous tibial nerve stimulation and a validated sham intervention in a multicenter trial of 220 adults with overactive bladder. Patients received their assigned treatments in 12 weekly 30-minute sessions.

On intent-to-treat analysis at 13 weeks, significantly more patients in the treatment group (60/11365, 54.5%) than in the sham group (23/11365, 20.9%) reported moderate or marked improvements in overall bladder symptoms.

Treated patients also reported significantly greater improvement in urinary urgency, frequency, and urge incontinence than sham patients, and their 3-day voiding diary daily results showed superior improvements in frequency, urinary urge incontinence episodes, nighttime voids, urgency episodes, and voids with moderate to severe urgency.

Condition-specific symptom severity scores and quality of life scores also showed significantly greater improvement with tibial nerve stimulation than with sham treatment.

Six treated patients reported nine mild or moderate local adverse events, compared with none in the sham group, but no one in either group had any systemic adverse events.

“This pivotal…trial provides level I evidence that percutaneous tibial nerve stimulation therapy is safe and effective in treating overactive bladder symptoms,” the researchers conclude.

Dr. Peters said he and his colleagues are now studying “the long-term effect of tibial nerve stimulation and the treatment interval that is required to maintain a clinical effect.” They are also working to see whether previous antimuscarinic therapy affects outcomes in their patients.

Reference:
J Urol 2010;183:1438-1443.