Posterior tibial nerve stimulation in the treatment of voiding dysfunction: urodynamic data.
OBJECTIVE
To determine urodynamic changes and predictive factors in patients with voiding dysfunction who underwent 12 percutaneous tibial nerve stimulations.


METHODS
Thirty nine patients with chronic voiding dysfunction were enrolled in a prospective multicenter trial in the Netherlands (n = 19) and in Italy (n = 20). A 50% reduction in total catheterised volume per 24 hr was taken as a primary objective outcome measure. Patients' request for continuation of treatment was regarded as subjective success. Objective urodynamic parameters and bladder indices were determined. Odds ratios and their 95% confidence interval were computed as a measure for predictive power in order to reveal predictive factors (Pdet at Qmax, Qmax, BVE, and BCI).


RESULTS
Primary outcome measure was obtained in 41%, an additional 26% reduced their 24 hr residuals with more than 25%. Fifty nine percent of patients chose to continue treatment. Detrusor pressure at maximal flow, cystometric residuals, and bladder indices improved significantly for all patients (P < 0.05). Patients with minor voiding dysfunction were more prone to notice success (Odds ratio: 0.73; 95% CI: 0.51-0.94).


CONCLUSIONS
PTNS is a young treatment modality, minimally invasive, and easily accessible. It might be an attractive first line option for patients with (minor) voiding dysfunction.
Vandoninck
Vera
V
Department of Urology, University Medical Center Nijmegen, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands.
van Balken
Michael R
MR
Finazzi Agrò
Enrico
E
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 / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D013979:Tibial Nerve / Q000502:physiology*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D014555:Urination Disorders / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology*