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Patient Characteristics associated with Successful PTNS Therapy for Overactive Bladder Symptoms after 12 Weekly Sessions - Ghazaleh Rostami Nia, MD, MSc
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A study aimed to identify predictors of successful percutaneous tibial nerve stimulation (PTNS) treatment for overactive bladder syndrome (OAB) found that a majority of patients experienced subjective and objective improvement after 12 weekly sessions of treatment. However, self-reported subjective improvement was only weakly associated with objective improvement based on voiding diaries. The study included 162 women with a mean age of 72.7 years who underwent PTNS therapy. The treatment involved weekly sessions with a nurse for 30 minutes over a span of 12 weeks. The PTNS technique involved stimulating the nerve using a needle electrode inserted near the ankle, delivering an electric current with specific parameters. Patients reported percentage estimates of subjective improvement before each treatment session and completed voiding diaries. Objective outcomes included improvements in inter-voiding interval, nocturia episodes, and urgency urinary incontinence episodes. The study found that a history of depression/anxiety and more severe baseline urinary urgency leakage were positive predictors of successful PTNS treatment, while a baseline history of >2 nocturia episodes was a negative predictor. Multivariable analysis also revealed associations between subjective outcomes and a history of breast cancer, hypertension, prior intravesical onabotulinumtoxin A injection, and prior sacral neuromodulation. The study concluded that while PTNS treatment led to improvements in OAB symptoms, there was only a weak correlation between self-reported improvement and objective outcomes. Various patient characteristics were identified as predictors of treatment success or less favorable outcomes. Statistical analyses were performed to evaluate the data, and all analyses were conducted using SAS software.
Keywords
percutaneous tibial nerve stimulation
PTNS treatment
overactive bladder syndrome
subjective improvement
objective improvement
voiding diaries
depression/anxiety
urinary urgency leakage
nocturia episodes
treatment success
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