title: Evaluation of Percutaneous Tibial Nerve Stimulation for Treatment of Refractory Painful Bladder Syndrome.
abstract: OBJECTIVE
  To evaluate the efficacy of intermittent percutaneous tibial nerve stimulation (PTNS) as a treatment modality for patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS).
  
  
  METHODS
  Twenty female patients with IC/BPS (mean symptom duration of 4.5 ± 2.4 years) each had a 30-minute session of PTNS per week for 12 successive weeks and the symptoms were assessed before, during, and after the treatment sessions by voiding diary, visual analog scale (VAS) for pain, interstitial cystitis symptom and problem indices (ICSI and ICPI), and global response assessment (GRA) scale. The scores of the previous questionnaires were evaluated at weeks 0, 6, and 12.
  
  
  RESULTS
  At week 0, the VAS, day time frequency, nocturia, and average voiding volume were 5.6 ± 1.1, 14.5 ± 4.0, 3.0 ± 0.9, and 131.8 ± 35.3 mL, respectively, meanwhile at week 12 these scores were 5.2 ± 1.5, 12.15 ± 3.7, 2.6 ± 0.7, and 141.0 ± 36.2, respectively. There was no statistically significant difference between the scores of the ICPI between weeks 0, 6, and 12 (P = .937). As regards the GRA score after the 12th session, 17 patients (85%) reported having no effect, 1 patient (5%) reported as having worse symptoms, and 2 patients (10%) reported having a mild good response.
  
  
  CONCLUSIONS
  Intermittent PTNS is not a satisfactory treatment for refractory IC/BPS. However, it is recommended to perform more studies with other treatment protocol (maybe closer sessions) to confirm these results.
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Maged M
authors.initials: MM
authors.lastname: Ragab
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Tawfik
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt. Electronic address: moh.aboelenen@yahoo.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abo El-enen
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elnady
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Osama M
authors.initials: OM
authors.lastname: El-Gamal
authors.affiliation: Tanta Insurance Hospital, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Kordy
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Gameel
authors.affiliation: Urology Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rasheed
mesh_terms: D000328:Adult; D018856:Cystitis, Interstitial / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013979:Tibial Nerve; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014554:Urination