Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK.
BJU Int. 2010 Dec;106(11):1673-6. doi: 10.1111/j.1464-410X.2010.09461.x.
To describe our initial outcome data following a shortened 6-week treatment protocol with percutaneous tibial nerve stimulation (PTNS) in women with overactive bladder syndrome (OABS) unresponsive to bladder retraining and anticholinergic therapy.
This was a prospective observational study over a 6-month period. In all, 43 women with OABS refractory to medical therapy were treated with a shortened PTNS protocol that consisted of 6 weekly 30 min sessions. Bladder symptom diaries and health-related quality of life (HRQL) assessed using the short-form seven-item self-report. Incontinence Impact Questionnaire (IIQ-7) were completed before and after treatment. A positive response was defined as: (i) OAB symptoms no longer being bothersome; (ii) reduction by half in frequency episodes and (iii) reduction by 25% in IIQ-7 outcomes.
All 43 women (median age 55.3 years) completed six treatments with a positive response rate of 69.7%. In the positive responders, the median daytime and nocturnal frequency was reduced by half after 6 weeks of treatment (11.8 vs 6.9 and 3.5 vs 1.8, respectively, P < 0.05) and the patients reported fewer urge leak episodes per 24 h (median 3.5 vs 2.4, P < 0.05). The median IIQ-7 scores improved by 25% (30.4 vs 24.3, P < 0.05) in responders, while the median number of pads changed in 24 h also decreased by 34% (3.8 vs 2.5, P < 0.05). The median acceptability of the technique when scored by Visual Analogue Score was 9.6/10 and no side-effects were reported.
A shortened 6-week treatment with PTNS appears to be successful, with a significant reduction in symptoms and improvement in HRQL. This early data suggest that the duration of treatment for peripheral neuromodulation can be halved compared with the conventional 12 weeks, which would make it more acceptable and cost effective for patients. A randomised controlled trial of 6 weeks vs 12 weeks of PTNS therapy would be useful in determining the optimal duration of treatment.
描述我们在经过 6 周的经皮胫神经刺激（PTNS）治疗后，对膀胱过度活动症（OAB）女性的初始结果数据，这些女性对膀胱训练和抗胆碱能治疗没有反应。
这是一项为期 6 个月的前瞻性观察研究。共有 43 名对药物治疗有抗药性的 OAB 女性接受了缩短的 PTNS 方案治疗，该方案包括每周 30 分钟，共 6 次。在治疗前后使用简短的七项自我报告来完成膀胱症状日记和健康相关生活质量（HRQL）评估。采用简短的尿失禁影响问卷（IIQ-7）来评估。阳性反应定义为：（i）OAB 症状不再令人困扰；（ii）频率发作减少一半；（iii）IIQ-7 结果减少 25%。
所有 43 名女性（中位年龄 55.3 岁）均完成了 6 次治疗，阳性反应率为 69.7%。在阳性应答者中，治疗 6 周后白天和夜间的频率均减少一半（分别为 11.8 次/9.8 次和 3.5 次/1.8 次，P < 0.05），且患者报告的 24 小时内急迫性漏尿次数减少（中位数为 3.5 次/2.4 次，P < 0.05）。应答者的 IIQ-7 评分中位数提高了 25%（30.4 分/24.3 分，P < 0.05），24 小时内的尿垫使用中位数也减少了 34%（3.8 片/2.5 片，P < 0.05）。使用视觉模拟评分法对技术的接受程度进行评分，中位数为 9.6/10，无不良反应报告。
经皮胫神经刺激（PTNS）的 6 周治疗似乎是成功的，症状有显著缓解，生活质量得到改善。这些早期数据表明，与传统的 12 周相比，外周神经调节的治疗时间可以减半，这将使患者更容易接受且更具成本效益。6 周与 12 周的 PTNS 治疗的随机对照试验将有助于确定最佳的治疗时间。
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