title: Combination of sacral neuromodulation and tolterodine for treatment of idiopathic overactive bladder in women: a clinical trial.
abstract: OBJECTIVE
  To evaluate the efficacy of intermittent percutaneous needle sacral nerve stimulation (IPN-SNS) in women with idiopathic overactive bladder (IOAB) treated with tolterodine.
  
  
  METHODS
  A total of 240 female patients diagnosed with IOAB were randomized to receive tolterodine only treatment (group 1, n = 120) or tolterodine combined with IPN-SNS (group 2, n = 120). Each group included 120 participants, who were divided into subgroups depending on whether they had dry OAB (urinary frequency and urgency) or wet OAB (urinary frequency and urgency with urgency incontinence). In the treatment group, patients received percutaneous IPN-SNS plus tolterodine (2 mg once daily), while in the control group, only tolterodine (2 mg once daily) was administered for 3 months. The voiding diary and urodynamic parameters were monitored, and patients' psychological depression and anxiety scores were recorded before and after treatment.
  
  
  RESULTS
  There were significantly greater improvements in the conditions of first desire to void (FDV), max­imum cystometric capacity (MCC), and daily average volumes, as well as the daily single maximum voided volumes in group 2 (P = .001) than in group 1. In addition, there were significantly greater decreases in self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores in group 2 compared with group 1 (P < .001).
  
  
  CONCLUSIONS
  Combined treatment with tolterodine plus IPN-SNS can not only improve the symptoms of voiding dysfunction but can also reduce the concomitant depression and anxiety in women with IOAB, there­by improving patients' quality of life.
authors.affiliation: Department of Urinary Surgery, The Second Hospital of Sanming, Yong'an, 366000, Fujian Province, China. tanghuaBM@163.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Urinary Surgery, The Second Hospital of Sanming, Yong'an, 366000, Fujian Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Urinary Surgery, The Second Hospital of Sanming, Yong'an, 366000, Fujian Province, China.
authors.forename: Yongfu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Urinary Surgery, The Second Hospital of Sanming, Yong'an, 366000, Fujian Province, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Yu
authors.affiliation: Department of Urinary Surgery, The Second Hospital of Sanming, Yong'an, 366000, Fujian Province, China.
authors.forename: Changping
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Urinary Surgery, The Second Hospital of Sanming, Yong'an, 366000, Fujian Province, China.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D003408:Cresols / Q000627:therapeutic use*; D003863:Depression / Q000209:etiology; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010665:Phenylpropanolamine / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D000068737:Tolterodine Tartrate; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D014556:Urine
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate