title: The outcome of adding peripheral neuromodulation (Stoller afferent neuro-stimulation) to anti-muscarinic therapy in women with severe overactive bladder.
abstract: OBJECTIVE
  Anti-muscarinic treatment alone and peripheral neuromodulation with concomitant anti-muscarinic treatment were compared in patients with severe overactive bladder.
  
  
  METHODS
  In this prospective study, 40 women with severe overactive bladder according to the 7-day voiding diary without any prior treatment completed the Incontinence Impact Questionnaire (IIQ-7) and were randomised into anti-muscarinic-alone and combination treatment groups. Twenty women received daily 4 mgs of tolterodine orally and in 20 women Stoller afferent neuro-stimulation (SANS) therapy was performed concomitantly for 12 weeks to the same anti-muscarinic regimen. After 12 weeks of therapy, two of the patients drop out of the study and remaining patients filled out the IIQ-7 questionnaire and the 7-day voiding diary again. Pretreatment and post-treatment QoL scores and the 7-day voiding diaries were compared. Mann-Whitney U, Wilcoxon and two sided significance tests were used.
  
  
  RESULTS
  Thirty-eight women fulfilling the criteria were included in the study. Severity of overactive bladder symptoms decreased significantly in both treatment groups. However, the decrease in combination treatment group was more significant than the anti-muscarinic-alone group. Adverse events were similar between the two groups.
  
  
  CONCLUSIONS
  Combining SANS and anti-muscarinic therapy resulted in significantly better clinical outcomes and IIQ-7 scores as compared with anti-muscarinic treatment alone in patients with severe overactive bladder.
authors.affiliation: Department of Obstetrics and Gynecology, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sancaktar
authors.forename: Seyit Temel
authors.initials: ST
authors.lastname: Ceyhan
authors.forename: Ilker
authors.initials: I
authors.lastname: Akyol
authors.forename: Murat
authors.initials: M
authors.lastname: Muhcu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Alanbay
authors.forename: Cihangir
authors.initials: C
authors.lastname: Mutlu Ercan
authors.forename: Vedat
authors.initials: V
authors.lastname: Atay
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003408:Cresols / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010665:Phenylpropanolamine / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate