Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Oviedo , Oviedo, España.
Fundación Hospital de Jove, Gijón, España.
Actas Urol Esp (Engl Ed). 2021 Apr;45(3):177-187. doi: 10.1016/j.acuro.2020.10.003. Epub 2021 Jan 19.
Overactive bladder syndrome (OBS) is a urological disorder characterized by urinary urgency, increased frequency, nocturia, and may be associated with urge urinary incontinence. Posterior tibial nerve peripheral neuromodulation (PTNS) is globally recognized within the treatment options available, although an optimal protocol has not been tested. The objective of this review is to collect the evidence available on the most widely used protocol of the PTNS technique in obtaining good results in the treatment for women with OBS.
A systematic review of the scientific literature was carried out in PubMed, Embase, WoS and Scopus databases. A total of 222 results were obtained, with 58 duplicates, of which 8 studies met the established inclusion criteria, all of them randomized clinical trials.
The included works show that the most widely used PTNS technique with beneficial results in women with OBS is the percutaneous route with a needle placed 5-6cm proximal to the tibial malleolus, posterior to the edge of the tibia, with the following parameters: 1 weekly session of 30minutes duration for 12 weeks, the use of pulse widths of 200μs with frequency of 20Hz.
PTNS may have beneficial and safe short-term effects in women with OBS. Despite showing statistically significant improvements in clinical symptoms, further research is needed to obtain clear scientific evidence on the optimal protocol for treating women with OBS.
膀胱过度活动症(OBS)是一种泌尿系统疾病,其特征为尿急、尿频、夜尿,并可能伴有急迫性尿失禁。胫后神经外周神经调节(PTNS)是一种全球公认的治疗方法,但尚未测试出最佳方案。本综述的目的是收集有关 PTNS 技术最广泛使用方案的证据,以获得治疗 OBS 女性的良好效果。
在 PubMed、Embase、WoS 和 Scopus 数据库中进行了科学文献的系统回顾。共获得 222 项结果,其中 58 项重复,其中 8 项研究符合既定纳入标准,均为随机临床试验。
纳入的研究表明,在 OBS 女性中使用最广泛且具有有益效果的 PTNS 技术是经皮途径,在胫骨内踝近端 5-6cm 处放置一根针,位于胫骨后缘,采用以下参数:每周 1 次,每次 30 分钟,持续 12 周,使用 200μs 的脉冲宽度,频率为 20Hz。
PTNS 可能对 OBS 女性具有短期的有益和安全效果。尽管在临床症状方面显示出统计学上的显著改善,但仍需要进一步的研究来获得关于治疗 OBS 女性的最佳方案的明确科学证据。