title: Transcutaneous tibial nerve stimulation in the treatment of lower urinary tract symptoms and its impact on health-related quality of life in patients with Parkinson disease: a randomized controlled trial.
abstract: OBJECTIVE
  A randomized controlled trial study was performed to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) and sham TTNS, in patients with Parkinson disease (PD) with lower urinary tract symptoms (LUTS).
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Thirteen patients with a diagnosis of PD and bothersome LUTS were randomly allocated to one of the following groups: Group I: TTNS group (n = 8) and group II: Sham group (n = 5). Both groups attended twice a week during 5 weeks; each session lasted 30 minutes.
  
  
  METHODS
  Eight patients received TTNS treatment and 5 subjects allocated to group II were managed with sham surface electrodes that delivered no electrical stimulation. Assessments were performed before and after the treatment; they included a 3-day bladder diary, Overactive Bladder Questionnaire (OAB-V8), and the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICIQ-SF), and urodynamic evaluation.
  
  
  RESULTS
  Following 5 weeks of treatment, patients allocated to TTNS demonstrated statistically significant reductions in the number of urgency episodes (P = .004) and reductions in nocturia episodes (P < .01). Participants allocated to active treatment also showed better results after treatment in the OAB-V8 and ICIQ-SF scores (P < .01, respectively). Urodynamic testing revealed that patients in the active treatment group showed improvements in intravesical volume at strong desire to void (P < .05) and volume at urgency (P < .01) when compared to subjects in the sham treatment group.
  
  
  CONCLUSIONS
  These findings suggest that TTNS is effective in the treatment of LUTS in patients with PD, reducing urgency and nocturia episodes and improving urodynamic parameters as well as symptom scores measured by the OAB-V8 and health-related quality-of-life scores measured by the ICIQ-SF.
authors.affiliation: Maria Carolina Perissinotto, PhD, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Carlos Arturo Levi D'Ancona, PhD, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Adélia Lúcio, PhD, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Renata Martins Campos, MSN, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Anelyssa Abreu, PhD, Universidade Estadual de Campinas-Unicamp, Department of Neurology, Campinas, São Paulo, Brazil.
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Perissinotto
authors.forename: Carlos Arturo Levi
authors.initials: CA
authors.lastname: DʼAncona
authors.forename: Adélia
authors.initials: A
authors.lastname: Lucio
authors.forename: Renata Martins
authors.initials: RM
authors.lastname: Campos
authors.forename: Anelyssa
authors.initials: A
authors.lastname: Abreu
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013979:Tibial Nerve / Q000502:physiology*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods / Q000401:mortality*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy; D053202:Urinary Incontinence, Urge / Q000517:prevention & control* / Q000628:therapy