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Posterior tibial nerve stimulation for overactive bladder-techniques and efficacy.

Alka A Bhide1, Visha Tailor2, Ruwan Fernando2

  • 1St Mary's Hospital, Imperial College NHS Trust, London, UK. alkabhide@doctors.org.uk.

International Urogynecology Journal
|December 20, 2019
PubMed
Summary

For overactive bladder, when medications fail, invasive treatments like tibial nerve stimulation are options. This review explores various tibial nerve stimulation techniques and their effectiveness for refractory symptoms.

Keywords:
ImplantableNeuromodulationOveractive bladderPercutaneousTibial nerve stimulationTranscutaneous

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Area of Science:

  • Urology
  • Neurology
  • Physical Medicine and Rehabilitation

Background:

  • Overactive bladder (OAB) treatment remains challenging, with medication often insufficient.
  • Invasive options for refractory OAB include botulinum toxin-A, sacral neural stimulation, and posterior tibial nerve stimulation.
  • Current guidelines position percutaneous posterior tibial nerve stimulation as a third-line therapy post-multidisciplinary review and failure of conservative/pharmacological methods.

Purpose of the Study:

  • To comprehensively review all techniques related to tibial nerve stimulation.
  • To evaluate the efficacy of different tibial nerve stimulation methods for overactive bladder.

Main Methods:

  • Literature review of tibial nerve stimulation techniques.
  • Analysis of efficacy data from published studies on tibial nerve stimulation for OAB.

Main Results:

  • Multiple tibial nerve stimulation techniques exist, varying in application and invasiveness.
  • Efficacy data suggests potential benefits for specific patient subgroups, but outcomes can be variable.
  • Further research is needed to optimize techniques and patient selection.

Conclusions:

  • Tibial nerve stimulation offers a less invasive alternative to other third-line OAB treatments.
  • Understanding the nuances of different stimulation techniques is crucial for successful application.
  • Personalized approaches to tibial nerve stimulation may improve outcomes for patients with refractory overactive bladder.