TPTNS: evaluation of a therapeutic option in the management of anticholinergic refractory overactive bladder
Reviewed by Ann Crump

This is a prospective study evaluating the tolerability and efficacy of transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urodynamically proven overactive bladder (OAB), who have failed anticholinergic treatment. Forty-three patients were studied and followed up over a period ranging from 2 to 30 months (mean 10.8 months). Effectiveness was assessed using the Urinary Symptom Profile (USP) and the Mesure du Handicap Urinaire (MHU) symptom score. The procedure was taught to patients by a dedicated nurse and they were advised to perform it for 20 minutes every day. When assessed at one month the treatment was successful in 53% of patients. Bladder capacity of 323 +/- 96 was the only predictive factor for treatment success. Of these patients at later follow-up only one patient had dropped out of treatment. TPTNS seems to be well tolerated and easy for patients to perform.The small study suggests a possible alternative to botulinum toxin injections or sacral nerve stimulation. It is easy to perform with a 50% chance of improvement. It may be seen by patients as a preferable option as there is no risk of needing to perform clean intermittent self catheterisation (CISC) and doesn’t require a permanent implant. It is also more ‘user friendly’ than standard posterior tibial nerve stimulation as it doesn’t require needles and the pads are easily used by patients. It will be interesting to see whether this success rate is reproducible by other groups on larger numbers of patients. 

Transcutaneous posterior tibial nerve stimulation: evaluation of a therapeutic option in the management of anticholinergic refractory overactive bladder.
Ammi M, Chautard D, Brassart E, et al.
INTERNATIONAL UROGYNECOLOGY JOURNAL
2014;25:1065-9.