Posterior tibial nerve stimulation: is the once-a-week protocol the best option?
OBJECTIVE
Aim of our study was to compare the results of posterior tibial nerve stimulation (PTNS) performed weekly with those of PTNS performed 3 times per week in patients with overactive bladder syndrome.


METHODS
Thirty-five patients (28 females, 7 males) with overactive bladder syndrome not responding to antimuscarinic therapy were enrolled in a prospective study. A total of 17 out of 35 patients were randomly assigned to group A and treated with a PTNS protocol based on weekly stimulation sessions; 18 out of 35 patients were randomly assigned to group B and treated with a PTNS protocol based on stimulation sessions performed 3 times per week. All subjects were evaluated by means of 24 h bladder diaries, quality of life questionnaires (I-QoL, SF36) and urodynamic evaluation before and after treatment. Patients were asked after each stimulation session to give their opinion on the efficacy of the treatment. We have considered ''success'' those patients who presented a reduction >50% of the micturition episodes/24 h (ME/24) or (if incontinent) of the incontinence episodes/24 h (IE/24). Results before and after treatments in both groups were collected and statistically compared.


RESULTS
As a whole, 11/17 patients (63%) in group A and 12/18 patients (67%) in group B were considered ''success''; 4/11 (36%) incontinent patients in group A and 5/11 (45%) incontinent patients in group B were completely cured after treatment. In both groups, patients reported subjective improvement after 6-8 stimulation sessions.


CONCLUSIONS
Our findings seem to show that the periodicity of stimulation does not effect the results of PTNS treatment. The advantage of more frequent stimulation sessions is to achieve earlier a clinical improvement.
Finazzi Agrò
E
E
Unit of Urology, Tor Vergata University, IRCCS S. Lucia Foundation, Viale Oxford 81, 99173 Rome, Italy. efinazzi@tin.it
Campagna
A
A
Sciobica
F
F
Petta
F
F
Germani
S
S
Zuccalà
A
A
Miano
R
R
D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013979:Tibial Nerve; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000503:physiopathology / Q000628:therapy*