title: Percutaneous tibial nerve stimulation in treatment of overactive bladder: when should retreatment be started?
abstract: OBJECTIVE
  To study the response to posterior tibial nerve stimulation in patients with overactive bladder refractory to medical treatment.
  
  
  METHODS
  A cohort of 53 patients were treated by posterior tibial nerve stimulation and followed up for a maximum of 24 months. All patients completed the International Consultation on Incontinence Modular Questionnaire-Short Form quality of life questionnaire and kept a urination diary to record the daytime urination frequency and night-time urination frequency. Urodynamic studies were also conducted.
  
  
  RESULTS
  At 6 months of follow-up, a cure/improvement rate of 92.4% (49 of 53 cases) had been achieved. Ten patients were given additional treatment and were excluded from subsequent follow-up analysis. At 12 months of follow-up, a cure/improvement rate of 91.69% had been achieved (39 of 43). At 24 months of follow-up, of the 16 patients initially included during the first year, a cure/improvement rate of 62.5% had been achieved (10 of 16). The first sensation of bladder filling had increased by the end of treatment, with differences observed before and after posterior tibial nerve stimulation (P ≤ .001). The average post-treatment bladder capacity had increased by 72.7 mL compared with the initial value (P ≤ .001). At 24 months of follow-up, the group of 16 patients evaluated recorded a significant worsening of night-time urination frequency (P ≤ .05) and quality of life (P ≤ .01).
  
  
  CONCLUSIONS
  Posterior tibial nerve stimulation is a good option for the treatment of overactive bladder. In our series, the optimal point to start retreatment would be at 24 months after therapy completion.
authors: Servicio de Urología del Hospital Universitario Virgen de la Victoria, Málaga, España. crmarchal@gmail.com
authors: Cristobal
authors: C
authors: Marchal
authors: Bernardo
authors: B
authors: Herrera
authors: Francisco
authors: F
authors: Antuña
authors: Felipe
authors: F
authors: Saez
authors: Juan
authors: J
authors: Perez
authors: Elisabeth
authors: E
authors: Castillo
authors: Juan
authors: J
authors: Cantero
authors: Francisco
authors: F
authors: Milla
authors: Javier
authors: J
authors: Machuca
authors: Maximino
authors: M
authors: Redondo
authors: Alejandro
authors: A
authors: Galacho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D019233:Retreatment; D013979:Tibial Nerve; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation; D053201:Urinary Bladder, Overactive / Q000628:therapy*