SUFU 2018: Clinical Experience with Posterior Tibial Nerve Stimulation in the Elderly

Austin, TX ( Dr. Cristina Palmer and colleagues presented a retrospective study of 53 patients, aged 65 or older, undergoing percutaneous tibial nerve stimulation (PTNS) from 2011 to 2017 at the University of California Irvine.  They examined variables including age, BMI, number of comorbidities, and alternate and additional treatments used, in addition to PTNS.

45% of the patients were male, 64% female. The average age was 75 years and the average BMI was 26 kg/m2.  A non-elderly control group of 20 patients was used. 

Following the PTNS treatment, 70% of patients had symptom improvement.  39% of patients utilized combination therapy during PTNS.  Following PTNS, 7 patients used an anticholinergic, 6 used a β-3 agonist, 5 had intravesical botox injections, and 2 had sacral neuromodulation.

After examination of all variables, the authors found that obese BMI (30+ kg/m2) was the only variable predicting failure of response (p=0.0024), which was the same as the control group.  Interestingly, the patients who had intravesical botox injection after PTNS, all reported symptom improvement, which may lead clinicians to guide treatment algorithms.  The authors describe how it is important to avoid, or decrease the use of anticholinergics as well as treatments that may be more invasive, with increased side effects, in an elderly population.

Presenter by: Cristina Palmer, DO

Authors: Cristina Palmer DO, Nobel Nguyen and Gamal Ghoniem MD, FACS, University of California Irvine, Orange, California

Written by: Cristina Palmer, DO. Female Urology, Pelvic Reconstruction, Voiding Dysfunction Fellow, Department of Urology, UC Irvine Medical Center, Orange, California at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting (SUFU 2018), February 27-March 3, 2018, Austin, Texas

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