Evaluation of percutaneous tibial nerve stimulation for treatment of refractory painful bladder syndrome

OBJECTIVE: To evaluate the efficacy of intermittent percutaneous tibial nerve stimulation (PTNS) as a treatment modality for patients with refractory PBS/IC.

METHODS: 20 female patients with painful bladder syndrome/interstitial cystitis (mean symptoms duration of 4.5 ± 2.4 years); each had a 30-minute session of PTNS per week for 12 successive weeks and the symptoms were assessed before, during and after the treatment sessions by voiding diary, visual analog scale (VAS) for pain, interstitial cystitis symptom and problem indices (ICSI and ICPI) and global response assessment scale (GRA). The scores of the previous questionnaires were evaluated at week 0, 6 and 12.

RESULTS: At week 0, the VAS, day time frequency, nocturia and average voiding volume were 5.6 ± 1.1, 14.5 ± 4.0, 3.0 ± 0.9, 131.8 ± 35.3 ml respectively, meanwhile at week 12 these scores were 5.2 ± 1.5, 12.15 ± 3.7, 2.6 ± 0.7, 141.0 ± 36.2 respectively. There was no statistically significant difference between the scores of the ICPI between weeks 0, 6 and 12 (P value was 0.937). As regards the global response assessment score after the 12th session; 17 patients (85%) reported having no effect, 1 patient (5%) reported as having worse symptoms and 2 patients (10%) reported having a mild good response.

CONCLUSION: Intermittent PTNS is not a satisfactory treatment for refractory PBS/IC. However, it is recommended to perform more studies with other treatment protocol (maybe closer sessions) in order to confirm these results.

Urology. 2015 Jul 15. pii: S0090-4295(15)00646-9. doi: 10.1016/j.urology.2015.06.041. [Epub ahead of print]

Ragab M1, Tawfik A1, Abo Elenen M2, Elnady M1, Elgamal O1, Elkordy M3, Gameel T1, Rasheed M1.

1Urology Department, Tanta university Hospitals, Tanta, Egypt.
2Urology Department, Tanta university Hospitals, Tanta, Egypt. 
3Tanta insurance hospital.