[Posterior tibial nerve stimulation for pelvic floor dysfunction. Review]

Pelvic floor dysfunction is a highly prevalent functional pathology that affects women and can present with different clinical symptoms that include urinary urgency with or without incontinence, diurnal and nocturnal frequency, urinary retention, fecal incontinence, obstructive defecation, sexual dysfunction and pelvic pain. Lately, concern arised as to offer patients an advanced therapy within an integral approach. This interest was first focused in sacral nerve root modulation, a key element for pelvic function. Neuromodulation is considered a normal characteristic of the nervous system that regulates or modifies the electric impulses that come from different nervous body tissues. Neuromodulation is carried out through sacral neurostimulation (SNS), posterior tibial nerve stimulation (PNTS), which are reversible non destructive therapies used for peripheric stimulation of nerves, ganglia, spinal medula and brain. Even though there is evidence of efficacy for sacral nerve stimulation at short, medium and long-term, there are two main concerns within this approach: invasivity and high cost. It seems posterior nerve tibial stimulation has the same neuromodulatory effect as the one obtained by sacral nerve stimulation through a less invasive route and lower cost.