Percutaneous tibial nerve stimulation (PTNS) improves overactive bladder (OAB) symptoms and decreases the number of nocturia episodes in patients who do not respond well to medication therapy, new study findings suggest.

In a retrospective study of 183 female patients (mean age 74 years; 83% white) treated at a urogynecology center, 12 weeks of PTNS (30 minutes per week) reduced voiding frequency by 1 hour, nocturia episodes by 0.8, and urge incontinence by 10 episodes per week, Shilpa Iyer, MD, of the University of Chicago, and colleagues reported in International Urogynecology Journal. Previously, patients voided every 1.6 hours, awoke 2 to 3 times nightly to void, and averaged 3 urge incontinence episodes daily.

Patients typically spent 2 years trying OAB medications before starting PTNS. Those who continued OAB medications during PTNS experienced no greater improvements in frequency, nocturia, or urinary incontinence than those who halted the drugs.

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Additionally, a quarter of patients reported a 75% or greater improvement from PTNS, and 61.5% reported a 50% or greater improvement to nurses during office visits. Having a higher number of PTNS sessions was associated with a significant 80% increase in subjective success (50% or more).

“We found both objective and subjective improvements in urinary frequency, nocturia, and urge incontinence with PTNS therapy in patients who were dissatisfied with OAB medication therapy,” Dr Iyer’s team stated. Future research should explore possible biological mechanisms, they said.

Notably, just 55% of patients continued with maintenance PTNS. Possible reasons included lack of transportation, subpar insurance coverage, or dissatisfaction of therapy.

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Iyer S, Laus K, Rugino A, et al. Subjective and objective responses to PTNS and predictors for success: a retrospective cohort study of percutaneous tibial nerve stimulation for overactive bladder. Intl Urogyn J. DOI: 10.1007/s00192-018-3822-0