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Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review
Marc P Schneider1, Tobias Gross2, Lucas M Bachmann3
1Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland; Brain Research Institute, University of Zürich and Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland.
Tibial nerve stimulation (TNS) shows promise for neurogenic lower urinary tract dysfunction (NLUTD). However, current evidence is limited, necessitating further high-quality studies to confirm its efficacy and safety.
Area of Science:
- Urology
- Neurology
- Rehabilitation Medicine
Background:
- Tibial nerve stimulation (TNS) is an emerging therapy for lower urinary tract dysfunction.
- Its potential application in patients with neurogenic lower urinary tract dysfunction (NLUTD) warrants investigation.
Purpose of the Study:
- To systematically review the existing evidence on the efficacy and safety of TNS for treating NLUTD.
Main Methods:
- A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
- Included studies comprised randomized controlled trials (RCTs), prospective cohort studies, retrospective case series, and case reports.
Main Results:
- Sixteen studies involving 469 patients were analyzed, examining both acute and chronic TNS.
- Significant improvements were observed in cystometric capacity, bladder volume, and reduced detrusor pressure. Chronic TNS also showed reductions in voids, leakages, and postvoid residual.
- No TNS-related adverse events were reported, though risk of bias and confounding was noted as high.
Conclusions:
- Preliminary data suggest TNS may be effective and safe for NLUTD.
- The current evidence base is limited by small, non-comparative studies with high risk of bias.
- Well-designed randomized controlled trials are essential for definitive conclusions on TNS for NLUTD.
