EFFECTIVENESS OF POSTERIOR TIBIAL NERVE NEUROMODULATION TREATMENT IN PATIENTS WITH OVERACTIVE BLADDER SYNDROME

Abstract

Introduction: overactive bladder is a syndrome characterized by urinary urgency, increased voiding frequency, and nocturia, with or without urinary incontinence, and with absence of urinary tract infection or other obvious disease. It has great economic and social repercussions with a negative impact on the patient's quality of life. The first-line treatment is behavioral modifications and bladder reeducation. A second line is the use of antimuscarinics. Posterior tibial neuromodulation is an important treatment option in patients who are resistant to previous treatments. The objective of this study is to analyze in patients with overactive bladder syndrome, the changes produced in nocturia, urinary incontinence and quality of life, with posterior tibial neuromodulation alone and combined with antimuscarinics, based on validated questionnaires and pad test that quantifies urinary loses in 24 hours. Material and method: quasi-experimental study in which patients referred to the Pelvic Floor Unit of the Rehabilitation Service of the Hospital Universitario de Toledo participated. Fifty-four patients completed the study. All patients received 1 session per week for 12 weeks of percutaneous tibialis posterior neuromodulation. Twenty-two patients were taking antimuscarinics simultaneously. Results: 84.8 % improved nocturia, 37 % the pad test, 42.6 % the International Consultation on Incontinence Questionnaire (ICIQ) and in terms of Bladder Control Self assessment Questionnaire (CACV): 75.9 % improved symptoms and 64.8 % discomfort. In our study, taking antimuscarinics did not provide significant results, although we observed that in other studies it did have a positive effect. Conclusions: percutaneous posterior tibial neuromodulation in patients with overactive bladder is effective by itself. Limitations: to assess the need to have a control group and follow-up and maintenance therapy over time.