Prognostic factors for successful percutaneous tibial nerve stimulation

Area of Science:

• Neurology
• Urology
• Pain Management

Background:

• Percutaneous tibial nerve stimulation (PTNS) is a neuromodulation therapy for lower urinary tract dysfunction and chronic pelvic pain.
• Identifying prognostic factors is crucial for patient selection to optimize PTNS outcomes.
• Test stimulation is a known prognostic factor, but patient characteristics require further investigation.

Purpose of the Study:

• To identify patient characteristics that predict successful outcomes in PTNS therapy.
• To improve patient selection for neuromodulation by understanding prognostic indicators.

Main Methods:

• A cohort of 132 patients (51 male, 81 female, mean age 53) underwent PTNS across 8 centers.
• Patients were treated for overactive bladder, non-obstructive urinary retention, or chronic pelvic pain.
• Micturition/pain diaries, quality of life questionnaires (SF-36), and logistic regression were used to evaluate prognostic factors.

Main Results:

• Objective success was achieved in 32.6% and subjective success in 51.5% of patients.
• Most clinical parameters showed no prognostic value.
• A low baseline SF-36 Mental Component Summary score was a significant negative predictor for both objective (OR 0.123) and subjective success (p = 0.006).

Conclusions:

• Poor mental health, as assessed by the SF-36 Mental Component Summary, is a negative predictor for PTNS success.
• Mental health status does not correlate with disease severity, suggesting its independent role in treatment outcomes.
• The SF-36 Mental Component Summary can serve as a valuable tool for selecting patients likely to benefit from PTNS.