title: Sustained effectiveness of percutaneous tibial nerve stimulation for overactive bladder syndrome: 2-year follow-up of positive responders.
abstract: OBJECTIVE
  The aim of the study was to describe effectiveness and safety of percutaneous tibial nerve stimulation (PTNS) at 2 years in women with overactive bladder (OAB) syndrome unresponsive to pharmacotherapy.
  
  
  METHODS
  Of 30 women who had initial positive response to PTNS, 23 continued to receive maintenance treatment and were reassessed at 2 years using bladder symptom diaries and the Incontinence Impact Questionnaire (IIQ-7). They were also questioned on acceptability and any adverse effects of long-term peripheral neuromodulative treatment.
  
  
  RESULTS
  Data from 23 women were available and 7 had been lost to follow-up. With maintenance treatment, the median nocturnal frequency at 2 years had decreased by 57 % (3.5 to 1.5 times/night), while the median IIQ-7 had reduced from 30.4 to 21.5 (both p<0.01) compared to pre-treatment baseline. Median nocturnal frequency and IIQ-7 scores at 2 years were comparable to those documented after initial response to treatment at 6 weeks, suggesting that maintenance therapy continued to suppress OAB symptoms. Daytime frequency and daily urgency incontinence episodes at 2 years were statistically similar to those documented at 6 weeks and remained lower than pre-treatment baseline (6.5 vs 11.8 and 2.0 vs 3.5, respectively, p<0.05). The women received a median of 8.42 treatments per year and the median length between treatments was 64.3 days. Apart from hypaesthesia in the toe of one responder lasting for 4 months, there were no reported side effects.
  
  
  CONCLUSIONS
  Women receiving PTNS for intractable OAB syndrome reported significant symptom relief at 2 years. This remains a safe mode of second-line treatment with excellent durability.
authors.affiliation: Incontinence Unit, North Middlesex University Hospital, London, UK. wai.yoong@nmh.nhs.uk
authors.forename: W
authors.initials: W
authors.lastname: Yoong
authors.forename: P
authors.initials: P
authors.lastname: Shah
authors.forename: R
authors.initials: R
authors.lastname: Dadswell
authors.forename: L
authors.initials: L
authors.lastname: Green
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013979:Tibial Nerve; D020429:Tibial Neuropathy / Q000209:etiology; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*