Posterior tibial nerve stimulation as neuromodulative treatment of lower urinary tract dysfunction

Purpose: Recently, intermittent percutaneous posterior tibial nerve stimula tion was introduced as a treatment modality filling the gap between conserv ative and surgical therapies in patients with certain types of lower urinar y tract dysfunction. Materials and Methods: In a prospective multicenter trial posterior tibial nerve stimulation was evaluated in 37 patients who presented with symptoms of bladder overactivity, that is the urgency and frequency syndrome and/or urge incontinence, and 12 with nonobstructive urinary retention. Results we re recorded in voiding diaries and on quality of life questionnaires before and after treatment. Patients were classified as responders, including tho se in whom therapy was successful and chose to continue treatment after the initial 12 weeks, and nonresponders, those who chose to stop treatment. Results: Overall, a positive response was seen in 60% of all patients. In p atients with bladder overactivity a statistically significant decrease was observed in leakage episodes, number of pads used, voiding frequency and no cturia, and an equal increase in mean and smallest volume voided. Improveme nts were also seen in nonobstructive urinary retention, including number of catheterizations, total and mean volume catheterized, and total and mean v olume voided. Disease specific quality of life and some domains of general quality of life improved, especially of bladder overactivity. Only mild sid e effects were observed. Conclusions: Posterior tibial nerve stimulation is a minimally invasive and successful treatment option for patients with certain types of lower urina ry tract dysfunction.