The main objective of this retrospective study is to determine the efficacy of transcutaneous posterior tibial nerve stimulation (TPTNS) in older patients with overactive bladder (OAB) syndrome. The secondary objective is to look for predictive factors of efficacy of this treatment.
All patients aged over 65 years with OAB syndrome for which TPTNS was introduced between 2010 and 2016 in two neuro-urology centers were included. Age, gender, etiology of OAB, urinary symptoms and detrusor overactivity (DO) were retrospectively collected. The main outcome was efficacy of TPTNS (i.e., purchase of the device between 3 and 6 months).
A total of 264 patients were included (mean age 74.1 ± 6.5 years; 63.3% of women), of whom 53% had neurogenic OAB. Urinary incontinence was reported by 83.7% of patients and DO was found on urodynamic studies in 154 patients. The overall efficacy of TPTNS was 45.1%. None of the tested factors were significantly predictive of efficacy, especially age (≥ 75 years, p = 0.62), associated stress urinary incontinence (p = 0.69) and presence of DO (p = 0.60), whether neurogenic or not.
TPTNS is an effective treatment in older patients with OAB syndrome. No predictive factors of efficacy were found, especially age and DO. This treatment seems to be a good alternative to antimuscarinics against overactive bladder in older adults.
European geriatric medicine. 2018 Jan 05 [Epub]
C Hentzen, R Haddad, S Sheikh Ismaël, C Chesnel, G Robain, G Amarenco, GRAPPPA, Clinical research Group of perineal dysfunctions in older adults
Department of Neuro-urology, Tenon Hospital, AP-HP, 4 Rue de la Chine, 75020, Paris, France. ., Department of Physical Medicine and Rehabilitation, Rothschild Hospital, AP-HP, Paris, France., Department of Neuro-urology, Tenon Hospital, AP-HP, 4 Rue de la Chine, 75020, Paris, France.