Posterior tibial nerve stimulation in the treatment of idiopathic nonobstructive voiding dysfunction.
OBJECTIVE
To evaluate the effect of stimulation of the posterior tibial nerve in the treatment of voiding dysfunction.


METHODS
Thirty-nine patients with chronic voiding dysfunction necessitating clean intermittent catheterization were enrolled in a prospective multicenter trial in the Netherlands (n = 19) and Italy (n = 20). They underwent 12 weekly sessions of posterior tibial nerve stimulation. Frequency/volume charts, an incontinence quality-of-life instrument, and the MOS 36-item Short-Form Health Survey were completed at 0 and 12 weeks. Subjective success was defined by the patient's positive response resulting in a request to continue treatment. Efficacy was based on analysis of the frequency/volume charts comparing the baseline values with the data at 12 weeks. A reduction of 50% or more in total catheterized volume was considered as an objective success (primary outcome measurement).


RESULTS
Of the 39 patients, 23 (59%) chose to continue treatment. The frequency/volume charts showed a 50% decrease in total catheterized volume in 16 (41%) of 39 patients. Additionally, 10 patients (26%) noted a reduction of 25% to 50% in their total catheterized volume. For all patients, the total catheterized volume decreased by a mean of -228 mL (range -49 to -528). The incontinence quality-of-life instrument and Short-Form Health Survey parameters improved significantly.


CONCLUSIONS
Percutaneous stimulation of the posterior tibial nerve seems to be an effective, minimally invasive option worth trying in patients with idiopathic voiding dysfunction. Improvement was seen in objective micturition parameters, as well as in subjective quality-of-life data.
Vandoninck
Vera
V
Department of Urology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
van Balken
Michael R
MR
Finazzi Agro
Enrico
E
Petta
Filomena
F
Micali
Francesco
F
Heesakkers
John P F A
JP
Debruyne
Frans M J
FM
Kiemeney
Lambertus A L M
LA
Bemelmans
Bart L H
BL
D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012648:Self Care / Q000706:statistics & numerical data; D013979:Tibial Nerve / Q000502:physiology*; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000706:statistics & numerical data; D016055:Urinary Retention / Q000628:therapy*; D014554:Urination / Q000502:physiology