Percutaneous Tibial Nerve Stimulation in the Office Setting: Real World Experience of Over 100 Patients

To examine the outcomes and compliance with percutaneous tibial nerve stimulation (PTNS) for overactive bladder symptoms (OAB).

Adults that had PTNS from 6/30/2011 to 10/8/2015 were retrospectively reviewed for demographics, co-pay, travel distance, employment status, history, symptoms, and treatments used before, during and after PTNS. Pearson's Chi-square, Fisher's exact, Wilcoxon rank and paired t tests were performed.

Of 113 patients (mean age 75 ± 12 years), most were women (65.5%), married (78.1%), and retired/unemployed (80.2%). Median distance to the clinic was 8.1 miles, and the median co-pay was $0. The most common indication for PTNS was nocturia (92.9%) followed by OAB with urgency urinary incontinence (75.2%), and urinary urgency/frequency (24.8%). Prior treatments included anticholinergics (75.2%), mirabegron (36.6%), behavioral modification (29.2%), pelvic floor physical therapy (18.6%) and others (19.5%). Patients completed a mean of 10.5 ± 3 of 12 planned weekly PTNS treatments. 40/105 (38.1%) used concomitant treatments (most commonly anticholinergics). 62/87 (71.3%) patients were improved at 6 weeks and 60/85 (70.6%) were improved at 12 weeks.. The majority (82; 75.6%) completed all 12 weekly treatments and 45 (54.9%) completed 3 (median) monthly maintenance treatments. The most common reason for non-compliance was lack of efficacy. Visit co-pay, employment status, and distance to clinic were not associated with failure to complete weekly treatments or progressing to monthly maintenance.

Although most patients improved after weekly PTNS, non-adherence to maintenance and lack of efficacy may limit long term feasibility. Co-pay and distance traveled were not associated with non-compliance.

Urology. 2017 Nov 28 [Epub ahead of print]

Evan R Sirls, Kim A Killinger, Judith A Boura, Kenneth M Peters

Department of Urology, Beaumont Health, Royal Oak, MI., Department of Urology, Beaumont Health, Royal Oak, MI; Oakland University Beaumont School of Medicine, Rochester, MI. Electronic address: ., Department of Urology, Beaumont Health, Royal Oak, MI; Oakland University Beaumont School of Medicine, Rochester, MI.