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Efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: Randomized control trial
Author(s) -
RamírezGarcía Inés,
BlancoRatto Laia,
Kauffmann Stèphanie,
CarraleroMartínez Andrea,
Sánchez Emília
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23843
Subject(s) - medicine , overactive bladder , randomized controlled trial , urination , statistical significance , confidence interval , quality of life (healthcare) , transcutaneous electrical nerve stimulation , ambulatory , urge incontinence , urology , surgery , urinary incontinence , urinary system , alternative medicine , nursing , pathology
Aim To evaluate the non‐inferiority of the transcutaneous electrical stimulation technique, as compared with the percutaneous therapy (PTNS), regarding the efficacy in symptoms and QoL improvement in patients with overactive bladder (iOAB). Methods Patients with overactive detrusor (DO) and persisting symptoms after first‐line or second‐line treatment were randomized to receive either transcutaneous therapy or PTNS 1 day a week (30 min at 20 Hz and 200 cycles/s) for 12 weeks. Data from a 3‐day voiding diary and a self‐reported QoL‐questionnaire were collected pre‐treatment and at week 12. Non‐inferiority was analyzed by estimating the mean change (95% confidence interval) of daytime micturition frequency. Statistical significance level was set at P < 0.05. Results Sixty‐eight patients were included (67.6% women), mean age 59.6 years (SD 16.1). According to ITT analysis, daytime frequency decreased in both groups without statistically significant differences between them at the end of the treatment (adjusted difference 0.8; 95%CI; −0.1; 1.7); nor were differences in symptoms improvement for the variables collected through the 3‐day voiding diary. Both techniques lessened urgency incontinence episodes by more than 50% and greatly improved the QoL. There were no relevant side effects and overall adherence to the treatment was 89.7%. Conclusions This is the first RCT that evaluates the efficacy of the transcutaneous technique compared to the PTNS, and demonstrates non‐inferiority in decreasing daytime frequency. Reduction in urgency incontinence episodes and improvement of QoL were also observed. These results and ease of application of transcutaneous neuromodulation may lead to a greater prescribing of this technique.