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Response to tibial and sacral nerve modulation in overactive bladder: Is there any correlation?
Mathieu Fourel1, Samy Hafez2, Nassima Ramdane3
1Department of Urology, Lille Academic Hospital, University of Lille, Lille, France.
Neurourology and Urodynamics
|December 11, 2023
Summary
Response to transcutaneous tibial nerve stimulation (TTNS) does not predict success with sacral nerve modulation (SNM) for overactive bladder (OAB). These neuromodulation therapies should be considered independently in OAB treatment decisions.
Area of Science:
- Urology
- Neuromodulation
- Overactive Bladder Treatment
Background:
- Overactive bladder (OAB) significantly impacts quality of life.
- Transcutaneous tibial nerve stimulation (TTNS) and sacral nerve modulation (SNM) are neuromodulation therapies used for OAB.
- Predicting SNM response based on TTNS outcomes could optimize treatment selection.
Purpose of the Study:
- To evaluate the correlation between patient response to TTNS and subsequent response to SNM for OAB treatment.
- To determine if TTNS efficacy predicts SNM success in a cohort of OAB patients.
Main Methods:
- A retrospective study included 92 OAB patients who underwent TTNS followed by two-stage SNM.
- Success was defined as a ≥50% improvement in bothersome urinary symptoms.
- Logistic regression analysis assessed the relationship between TTNS and SNM response, controlling for age, gender, and neurological conditions.
Main Results:
- TTNS success rate was 23.9% (22/92), while SNM test phase success was 71.7% (66/92).
- No statistically significant correlation was found between TTNS response and SNM response in the overall population (p=0.51).
- This lack of correlation persisted when controlling for age subgroups.
Conclusions:
- Response to TTNS is not a reliable predictor of SNM response in OAB patients.
- TTNS and SNM should be regarded as distinct treatment options.
- Clinical decision-making for OAB management should consider these therapies independently.
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