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Int Neurourol J > Accepted Articles
DOI: https://doi.org/10.5213/inj.2040408.204    [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: florian.girtner@ukr.de
Submitted: 30 October 2020;  Accepted after revision: 21 December 2020.
ABSTRACT
Purpose
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.
Methods
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.
Results
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).
Conclusions
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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Official Journal of Korean Continence Society & ESSIC (International Society for the Study of BPS) & Korean Society of Urological Research & The Korean Children’s Continence and Enuresis Society & The Korean Association of Urogenital Tract Infection and Inflammation & Korean Society of Geriatric Urological Care
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