SUFU 2019: Early Evaluation of an Implanted Chronic Tibial Nerve Stimulation Device Versus Percutaneous Nerve Stimulation for the Treatment of Urinary Urge Incontinence

Miami, FL (UroToday.com) Current prescription for the in-clinic posterior nerve stimulation (PTNS) is 30-minutes per session. However, this timeframe can potentially limit the therapeutic effect of the device. Novel neuromodulation system was tested in women with overactive bladder by the researchers from the Beaumont Hospital, Royal Oak, and Oakland University School of Medicine. 

Chronic tibial nerve stimulation (CTNS) delivers wireless energy via implant, which is placed retrograde next to the tibial nerve under the local anesthesia in clinic (Figure 1).
Chronic_tibial_nerve_stimulation_demonstration.png

Patients wore ankle bracelets with wireless antenna while on a study treatment (Figure 2). 
CTMS_AnkleBracelet.png
A total of 9 women, who reported urinary issues for at least 6 months and at least one urge urinary incontinence episode per day, were enrolled into the randomized trial of conventional PTNS vs CTNS. Five women have received wireless implants, and 4 participants were assigned to a standard of care. CTNS lasted for 6-8 hours per day while PTNS sessions were 30-minutes each. Both groups were followed for 12 weeks.

The study showed a significant improvement in symptoms at 4 weeks after treatment initiation for the CTNS participants compared to the PTNS recipients who improved by week 13 (Figure 3). 
SymptomImprovement CTNSPTNS
Two women from the control group opted to receive CTNS implant post initial 12 weeks. All subjects reported improvement in symptoms and quality of life measures. They will be followed for 12 months.

Preliminary data show that CTNS can be an effective therapy option for patients with urinary incontinence. Only minor adverse events were reported by the participants to date, all have resolved.


Presented by: Larry T Sirls, MD, Beaumont Hospital, Royal Oak, Oakland University School of Medicine

Co-authors: Amanda Schonhoff, RN, Beaumont Hospital, Royal Oak, Angela Waldvogel, RN, Beaumont Hospital, Royal Oak, Deborah Hasenau, RN, Beaumont Hospital, Royal Oak, Kenneth M Peters, MD, Beaumont Hospital, Royal Oak, Oakland University School of Medicine

Written by: Hanna Stambakio, BS, Clinical Research Coordinator, Division of Urology, University of Pennsylvania, Twitter: @AStambakio at  the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2019, February 26 - March 2, 2019, Miami, Florida
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