Robert Pickard led the peer-review process as the Associate Editor responsible for the paper.
Article first published online: 20 AUG 2012
Copyright © 2012 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 32, Issue 3, pages 206–214, March 2013
How to Cite
Moossdorff-Steinhauser, H. F.A. and Berghmans, B. (2013), Effects of percutaneous tibial nerve stimulation on adult patients with overactive bladder syndrome: A systematic review. Neurourol. Urodyn., 32: 206–214. doi: 10.1002/nau.22296
Conflict of interest: none.
- Issue published online: 18 MAR 2013
- Article first published online: 20 AUG 2012
- Manuscript Accepted: 6 JUL 2012
- Manuscript Received: 7 APR 2012
- electric stimulation;
- tibial nerve;
- urinary incontinence
To assess the effectiveness of percutaneous tibial nerve stimulation (PTNS) on adult patients with overactive bladder syndrome, using a systematic review of randomized controlled trials (RCTs), clinical controlled trials (CCTs), and prospective observational cohort studies.
A computer-aided literature search was performed in: PubMed, EMBASE and CENTRAL (2000 to November 15, 2011) to identify RCTs, CCTs, and prospective observational cohort studies. The study had to investigate the effect of PTNS on overactive bladder syndrome. The methodological quality of each study was assessed and a qualitative analysis was performed to establish the levels of evidence.
Four RCTs and six prospective observational cohort studies were identified. There is strong evidence for the efficacy of PTNS versus a sham treatment. There is limited evidence that the use of PTNS and tolterodine ER is equally effective. No additional effect of a combination of Stoller afferent nerve stimulation (SANS) and anticholinergic medication compared to SANS alone. Most cohort studies suggested decreased frequency and improvement of incontinence and nocturia. However, the level of evidence was insufficient to make any firm conclusions. Because the total duration of all included trials varied between 6 and 12 weeks, so far there is little information on treatment periods.
PTNS is efficacious for frequency and urgency urinary incontinence. More high quality studies are needed to improve the level of evidence concerning the efficacy of PTNS with regard to urgency and nocturia, to specify patient selection criteria, optimal treatment modalities and long-term effects as well as the effectiveness in more pragmatic trials. Neurourol. Urodynam. 32: 206–214, 2013. © 2012 Wiley Periodicals, Inc.