Charvolin L, Guinet-Lacoste A, Waz D, Godmer M, Rode G
Hôpital Henry-Gabriel, 69230 Saint Genis-Laval, France.
Service de rééducation post-réanimation, hôpital Pierre-Wertheimer, 59, boulevard Pinel, 69677 Bron, France.
Prog Urol. 2019 Jul;29(7):378-384. doi: 10.1016/j.purol.2019.02.006. Epub 2019 Mar 12.
To investigate efficiency and tolerance of transcutaneous tibial nerve stimulation (TNS) in the overactive bladder syndrome in patients with Parkinson's disease (PD), and to identify predictive factors for compliance.
We conducted a retrospective monocentric study with a cohort of 17 patients with PD who have used TNS for an overactive bladder syndrome. The efficiency of the treatment was evaluated on the clinical improvement felt (rated out of ten). Patients were classified as « adopters » if they continued using TNS for at least one year after beginning the treatment or as « non adopters » if they stopped. Patients characteristics were evaluated for their predictive value for compliance with TNS.
Out of 17 patients, there were 9 women and 8 men, median age 66 years (55-77), median history for Parkinson's disease 8 years (1-22) and for urinary symptoms 3 years (1-10). Subjective efficiency was seen in 10 patients (59%), on nocturia and/or urinary incontinence for 9 patients (mean efficiency 5.75/10 and median efficiency 6.5/10). Three patients found TNS not effective, and four patients didn't use it long enough to evaluate. Two patients had side effects and stopped the TNS (feeling of electricity and restless leg syndrome). 7 patients were classified as « adopters » and 10 patients as « non adopters » after one year. Most evaluated characteristics proved not to be of predictive value for compliance with TNS except nocturia and pollakiuria (P=0.03 and P=0.05).
Our study seems to reveal TNS is particularly effective on nocturia and urge. Moreover, nocturia and pollakiuria appear to be predictive factors for SNT compliance. Nocturia could be a prominent symptom in SNT's prescription. But studies with more patients should be conducted for obtain better patient selection in TNS.
IV.
探讨经皮胫神经刺激（TNS）治疗帕金森病（PD）患者膀胱过度活动症的疗效及耐受性，并确定依从性的预测因素。
我们进行了一项回顾性单中心研究，纳入了17例使用TNS治疗膀胱过度活动症的PD患者。根据患者自身感觉的临床改善情况（以十分制评分）评估治疗效果。开始治疗后持续使用TNS至少一年的患者被分类为“采用者”，停止使用的患者被分类为“非采用者”。评估患者特征对TNS依从性的预测价值。
17例患者中，女性9例，男性8例，中位年龄66岁（55 - 77岁），帕金森病中位病程8年（1 - 22年），泌尿系统症状中位病程3年（1 - 10年）。10例患者（59%）主观感觉有效，9例患者夜尿和/或尿失禁症状改善（平均有效率5.75/10，中位有效率6.5/10）。3例患者认为TNS无效，4例患者使用时间不足无法评估。2例患者出现副作用并停止使用TNS（触电感觉和不安腿综合征）。一年后，7例患者被分类为“采用者”，10例患者为“非采用者”。除夜尿和尿频外，大多数评估特征对TNS依从性无预测价值（P = 0.03和P = 0.05）。
我们的研究似乎表明TNS对夜尿和尿急特别有效。此外，夜尿和尿频似乎是TNS依从性的预测因素。夜尿可能是TNS处方中的一个突出症状。但需要进行更多患者参与的研究，以便在TNS治疗中更好地选择患者。
IV级
