Preyer Oliver, Umek Wolfgang, Laml Thomas, Bjelic-Radisic Vesna, Gabriel Boris, Mittlboeck Martina, Hanzal Engelbert
Zell am See Hospital, Department of Obstetrics & Gynaecology, Paracelsusstrasse 8, A-5700 Zell am See, Austria.
Medical University of Vienna, Department of Obstetrics & Gynaecology, Division of General Gynaecology and Gynaecologic Oncology, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Eur J Obstet Gynecol Reprod Biol. 2015 Aug;191:51-6. doi: 10.1016/j.ejogrb.2015.05.014. Epub 2015 Jun 3.
We performed a randomised controlled trial of percutaneous tibial nerve stimulation (PTNS) versus tolterodine for treating treatment naïve women with overactive bladder (OAB).
36 patients with symptoms of OAB were randomised to 3 months of treatment with weekly PTNS or tolterodine (2mg bid p.o.). The primary outcome measure was the difference of micturitions per 24h. The secondary outcome measure was the impact on quality of life (QoL) measured with a visual analogue scale (VAS) between baseline and after 3 months of therapy.
Micturition frequencies did not decline significantly (p=0.13) over time and there were no significant treatment differences (p=0.96). QoL was significantly dependent from its level at baseline (p=0.002) and showed improvement over time compared to baseline measurements but no significant differences between both treatment groups (p=0.07). Incontinence episodes per 24h depended significantly on the level at baseline (p=0.0001) and declined significantly (p=0.03) during 3 months of therapy in both therapy groups. However no significant treatment differences on the reduction of incontinence episodes in 24h could be shown between both therapy groups (p=0.89). PTNS had fewer side effects than tolterodine (p=0.04).
PTNS and tolterodine were both effective in reducing incontinence episodes and improving QoL in patients with OAB but not micturition frequencies. PTNS had fewer side effects.
我们进行了一项随机对照试验，比较经皮胫神经刺激（PTNS）与托特罗定治疗初治膀胱过度活动症（OAB）女性的疗效。
36例有OAB症状的患者被随机分为两组，分别接受为期3个月的每周一次PTNS治疗或托特罗定治疗（口服2mg，每日两次）。主要结局指标是24小时排尿次数的差异。次要结局指标是通过视觉模拟量表（VAS）测量的治疗3个月前后对生活质量（QoL）的影响。
排尿频率随时间没有显著下降（p = 0.13），且治疗组之间没有显著差异（p = 0.96）。生活质量显著依赖于基线水平（p = 0.002），与基线测量相比随时间有所改善，但两组治疗之间没有显著差异（p = 0.07）。每24小时的尿失禁发作次数显著依赖于基线水平（p = 0.0001），并且在两个治疗组治疗3个月期间均显著下降（p = 0.03）。然而，两组治疗组在减少24小时尿失禁发作次数方面没有显著差异（p = 0.89）。PTNS的副作用比托特罗定少（p = 0.04）。
PTNS和托特罗定在减少OAB患者尿失禁发作次数和改善生活质量方面均有效，但对排尿频率无效。PTNS的副作用更少。
