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DOI:    [Accepted]
Randomised Crossover-Controlled Evaluation of Simultaneous-Bilateral Transcutaneous Electrostimulation of the Posterior Tibial Nerve During Urodynamic Studies on Patients With Lower Urinary Tract Symptoms
Florian Girtner1, Hans-Martin Fritsche1, Florian Zeman2, Toni Huber1, Maximilian Haider1, Christoph Pickl1, Maximilian Burger1, Roman Mayr1
1Department of Urology, University of Regensburg, Caritas St. Josef Medical Centre, Regensburg, Germany
2Centre for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
Correspondence  Florian Girtner ,Email:
Submitted: 30 October 2020;  Accepted after revision: 21 December 2020.
Transcutaneous tibial nerve stimulation (TTNS) has proven itself a valuable treatment option for various lower urinary tract conditions like the overactive bladder syndrome or neurogenic detrusor overactivity. The aim of this study was to investigate acute changes in urodynamic parameters due to bilateral TTNS.
51 patients (18 – 87 years; 61 % female) with various lower urinary tract symptoms were enrolled in this study. They were single-blinded and randomly assigned to receive simultaneous-bilateral TTNS either during their first urodynamic examination, followed by a second round under the influence of a placebo stimulation technique, or vice versa.
For subjects without signs of anatomical pathologies filling volume at the first desire to void (FDV) increased significantly by 54 ml (IQR 26 to 81; p < 0.01) under the influence of TTNS compared to placebo. Their maximum cystometric capacity increased by 41 ml (IQR 10 to 65; p = 0.02). The median micturition volume of patients with pathological amounts of post-void residual (>100 ml) increased by 76 ml compared to patients without urinary retention (IQR 6 to 166; p = 0.03).
Compared to placebo, simultaneous-bilateral TTNS showed significant improvements of bladder functioning like delayed FDV, increased maximum cystometric capacity and reduced urinary retention. Patients with signs of anatomical pathologies do not seem to benefit from TTNS. Further studies need to be conducted to compare the effectiveness of bilateral to unilateral TTNS.
Keywords: Percutaneous tibial nerve stimulation; Overactive bladder; Transcutaneous neuromodulation; Tibial nerve stimulation; Lower urinary tract symptoms; Urodynamics
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