Authors (including presenting author) :
Sy YW(1), Lau KY(1), So WL(1), Kung WC(1) , Lui KL(1) , Li SK(1) , Wong KW(1),Chan NH(1) , Li CM(1) , Tang CN(1)
Affiliation :
(1)Department of Surgery, Pamela Youde Nethersole Eastern Hospital
Introduction :
Overactive bladder syndrome (OAB) is a very common problem but not all patients respond well to first-line (behavioral therapies) and second-line (Pharmacologic management) treatments. Percutaneous tibial nerve stimulation (PTNS) therapy has been proposed as a new alternative, minimally invasive technique for OAB. PTNS is a peripheral type of neuromodulation by using an electrical stimulation via percutaneous needle to stimulate the posterior tibial nerve at the ankle level. This study is to evacuate the initial experience of PTNS for OAB patients in our day surgical ward.
Objectives :
To evaluate the efficacy of this new treatment with regard to its applicability, safety and side effects.
Methodology :
The study was conducted from June 2014 to June 2019. All adult patients with the urodynamic diagnosis of OAB who refractory to first and second line treatments and agreed for PTNS were recruited. Before enrollment of PTNS, all oral medication therapy would be stopped. Patients were required to record 3-day voiding diary and filled in Overactive Bladder Symptom Score (OABSS), Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). Patients would undergo a thirty minutes weekly therapy for twelve consecutive weeks. Patients would then refill the voiding diary and assessment scores for evacuation.
Result & Outcome :
During the period of June 2014 to June 2019, 76 patients (13 males: 63 females) were recruited into the study. The mean age was 57 years old (aged 27- 83). The results showed a significant decreased in frequency and urgency after PTNS. The mean daytime voids decreased from 14.21 to 7.13 (p< 0. 05). The mean number of nocturia decreased from 3.12 to 2.13 (p=0.05). The number of urge incontinence episodes per day were significantly decreased from 2.75 to 1.30 (p< 0.05). The mean maximal voiding capacity increased from 110 ml to 223ml (p< 0.05) and the mean minimal voiding capacity increased from 32ml to 106ml (p< 0.05). The mean OABSS decreased from 14.0 to 9.0 (p< 0.05), the mean UDI-6 score decreased from 8.5 to 6.5 (p< 0.05) and the mean IIQ-7 score decreased from 14.7 to 12.6 (p< 0.05). There were no complications or adverse events during or after PTNS.
