title: The Clinical and Urodynamic Results of Percutaneous Posterior Tibial Nerve Stimulation on Neurogenic Detrusor Overactivity in Patients With Parkinson's Disease.
abstract: OBJECTIVE
  To investigate the effect of percutaneous posterior tibial nerve stimulation (PTNS) treatment after 12 weeks on urodynamic and clinical findings in patients with Parkinson's disease (PD) with neurogenic detrusor overactivity.
  
  
  METHODS
  A total of 47 patients with PD with neurogenic detrusor overactivity were enrolled in the study. Urodynamic studies before and after 12-week PTNS treatment were performed. International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder Questionnaire (OAB-V8), and Overactive Bladder Questionnaire Short Form (OAB-q SF) have been assessed before and after PTNS treatment.
  
  
  RESULTS
  The mean first involuntary detrusor contraction volume (1st IDCV) on standard cystometry was 133.2 ± 48.1 (24-265) mL, whereas it was 237.3 ± 43.1 (145-390) mL after PTNS. The mean maximum cystometric capacity (MCC) on standard cystometry was 202.2 ± 36.5 (115-320) mL, whereas it was 292.1 ± 50.6 (195-395) mL after stimulation. The improvements in the first involuntary detrusor contraction volume and maximum cystometric capacity were statistically significant after stimulation. The mean Pdetmax at first involuntary detrusor contraction, maximal detrusor pressure at maximum cystometric capacity, PdetQmax, Qmax, and post-void residual volume were statistically significant after 12-week stimulation. Mean parametric improvements at 12-week PTNS treatment from baseline included daytime frequency decreased by 5.6 voids daily, urge incontinence decreased by 3.1 episodes daily, urgency episodes decreased by 6.3 episodes daily, nocturia decreased by 2.7 voids, and voided volume improved by a mean of 92.6 mL. The change from baseline on the ICIQ-SF, OABv8, and OAB-q at 12-week PTNS treatment demonstrated statistically significant improvements.
  
  
  CONCLUSIONS
  These results have demonstrated that PTNS improves the lower urinary tract symptoms and urodynamic parameters in patients with PD.
authors.affiliation: Department of Urology, Dumlupinar University Faculty of Medicine, Kutahya, Turkey. Electronic address: skabay@yahoo.com.
authors.forename: Sahin
authors.initials: S
authors.lastname: Kabay
authors.affiliation: Department of Neurology, Dumlupinar University Faculty of Medicine, Kutahya, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Canbaz Kabay
authors.affiliation: Department of Urology, Dumlupinar University Faculty of Medicine, Kutahya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetiner
authors.affiliation: Department of Urology, Dumlupinar University Faculty of Medicine, Kutahya, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Mestan
authors.affiliation: Department of Urology, Dumlupinar University Faculty of Medicine, Kutahya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sevim
authors.affiliation: Department of Neurology, Dumlupinar University Faculty of Medicine, Kutahya, Turkey.
authors.forename: Selahattin
authors.initials: S
authors.lastname: Ayas
authors.affiliation: Department of Anatomy, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
authors.forename: Hilmi
authors.initials: H
authors.lastname: Ozden
authors.affiliation: Department of Neurology, Canakkale 18 Mart University Faculty of Medicine, Canakkale, Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Ozisik Karaman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D011795:Surveys and Questionnaires; D013979:Tibial Nerve; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology*