The treatment of overactive bladder syndrome (OABS) by percutaneous pelvic nerve stimulation (PTNS) is usually recommended as a third line treatment. The purpose of this work was to compare PTNS alone on idiopathic OABS in women against a treatment combining PTNS and pelvic floor muscle training (PFMT).
This was a retrospective comparative study of 58 patients, followed at the urodynamic unit. Thirty patients received PTNS alone and 28 PTNS+pelvic floor rehabilitation. The main instrument used to measure the outcomes was the voiding diary.
The average age of our patients was 55.2 years. In the PTNS group, there was a significant improvement in daily micturitions (6 after PTNS vs. 10 before, P<0.001), nocturia (1.08 after PTNS vs. 1.75 before, P=0.003), urgency (7 daily before PTNS vs. 11 before (P<0.001) and maximum voided volume (378mL after PTNS vs. 306mL before, P=0.004). The Ditrovie score and USP scores showed a significant decrease. In the PTNS+PFMT group, a significant improvement was noted for the criteria: daily frequency episodes (5.7 after PTNS+PFMT vs. 7.56 before, P<0.001), nocturia (1.4 after PTNS+PFMT vs. 2.3 before, P=0.001), and daily urgency episodes (7 after PTNS+PFMT vs. 9 before, P<0.01). The OAB and SUI USP scores and the Ditrovie score decreased significantly (USP SUI score: 1.2 after PTNS+PFMT vs. 3.4 before (P<0.001) ; USP OAB score: 5.2 after PTNS+PFMT vs. 10.4 before, P<0.001). The comparison of the two groups (PTNS vs. PTNS+PFMT) did not show any significant difference in the voiding dairy outcomes and in the subjective scores outcomes (USP and Ditrovie).
No significant difference was observed concerning outcomes following PTNS alone and combined PTNS and PFMT in women presenting OABS.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2020 Jul 15 [Epub ahead of print]
R Baati, S Balhi, A Saadi, R Kraiem, B Kennou, H Ayed, M Chebil
Service d'urologie, hôpital Charles Nicolle de Tunis, Tunis, Tunisie. Electronic address: ., Département de médecine préventive, faculté de médecine de Tunis, Tunis, Tunisie., Service d'urologie, hôpital Charles Nicolle de Tunis, Tunis, Tunisie.