Percutaneous tibial nerve stimulation: a clinically and cost effective addition to the overactive bladder algorithm of care.
Overactive bladder affects millions of adults, with profound personal and economic costs. Although antimuscarinic drugs can cause a reduction in voiding symptoms, the effect is modest, and many patients are intolerant of the side effects, or do not experience sufficient relief. For these patients, the modulation of bladder reflex pathways via percutaneous tibial nerve stimulation (PTNS) or via implanted sacral nerve stimulation (SNS) has been acknowledged as a logical next step in the algorithm of care. This review examines the mechanism of action, the relative benefits, adverse effects, and costs of percutaneous nerve stimulation compared to other treatment modalities.
Department of Urology, Tufts University School of Medicine, Boston, MA, USA. staskin@att.net
David R
DR
Staskin
Kenneth M
KM
Peters
Scott
S
MacDiarmid
Neal
N
Shore
William C
WC
de Groat
D000328:Adult; D000465:Algorithms; D003362:Cost-Benefit Analysis; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000191:economics; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D011788:Quality of Life; D013979:Tibial Nerve; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation*; D053201:Urinary Bladder, Overactive / Q000628:therapy*
D018727:Muscarinic Antagonists