title: Percutaneous Tibial Nerve Stimulation Improves Female Sexual Function in Women With Overactive Bladder Syndrome.
abstract: BACKGROUND
  Percutaneous tibial nerve stimulation (PTNS) is an established treatment for overactive bladder (OAB), especially in women with other concomitant pelvic disorders, such as sexual impairment.
  
  
  OBJECTIVE
  To evaluate the impact of PTNS on female sexual dysfunction (FSD) in women undergoing PTNS for OAB and analyze the results.
  
  
  METHODS
  An observational prospective study was conducted in two Italian centers. Consecutive women undergoing PTNS for dry OAB were enrolled from May 2013 to June 2014. All patients were asked to complete the Female Sexual Function Index (FSFI), the OAB short-form questionnaire, and a 24-hour bladder diary at baseline and 3 months later, at the end of the PTNS course. Patients with an FSFI total score no higher than 26.55 at inclusion were considered as presenting with FSD. Patients with an FSFI total score higher than 26.55 after treatment (if the increase in FSFI score was ≥20%) were considered FSD objective responders.
  
  
  METHODS
  Sexuality was assessed using the FSFI. The 24-hour bladder diary and completed OAB short-form questionnaire were assessed before and after PTNS to evaluate OAB symptoms.
  
  
  RESULTS
  Forty-one women were evaluable. Twenty-one of 41 women (51%; mean age = 51 ± 10.67 years) were considered affected by FSD at inclusion. All FSFI domains showed statistically significant improvement in women with FSD (P < .05). In particular, 9 of 21 patients with FSD (43%) objectively responded (before treatment: mean FSFI total score = 18.11, range 10.8-26.3; after treatment: mean FSFI total score = 31.04, range 27.6-35). Also, women without FSD at baseline reported statistically significant improvement in their sexual function based on FSFI scores (P < .05). No significant correlations were seen between data questionnaires.
  
  
  CONCLUSIONS
  PTNS improves sexual function in women with dry OAB. This amelioration is independent of urinary symptoms. Further studies are needed to confirm a possible role of PTNS in treating FSD.
authors.affiliation: Department of Neuro-Urology, Careggi University Hospital, Florence, Italy. Electronic address: stefaniamusco@hotmail.com.
authors.forename: Stefania
authors.initials: S
authors.lastname: Musco
authors.affiliation: Department of Obstetrics and Gynecology, Urogynecology Unit, University of Insubria, Varese, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: Department of Neuro-Urology, Careggi University Hospital, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lombardi
authors.affiliation: Department of Urology, Tor Vergata University Hospital, Rome, Italy.
authors.forename: Ermal
authors.initials: E
authors.lastname: Lumi
authors.affiliation: Neuro-Urology Unit, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Annunziata Isabella
authors.initials: AI
authors.lastname: Parisi
authors.affiliation: Department of Neuro-Urology, Careggi University Hospital, Florence, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Del Popolo
authors.affiliation: Department of Experimental Medicine and Surgery, Unit of Functional Urology, Tor Vergata University, Tor Vergata University Hospital, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Finazzi Agrò
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013979:Tibial Nerve; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*
keywords: Female Sexual Dysfunction; Neuromodulation; Overactive Bladder; Percutaneous Tibial Nerve Stimulation