Pamukkale University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, 20100 Kınıklı, Denizli, Turkey.
Pamukkale University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, 20100 Kınıklı, Denizli, Turkey.
Ann Phys Rehabil Med. 2022 Jan;65(1):101486. doi: 10.1016/j.rehab.2021.101486. Epub 2021 Nov 11.
Different studies have reported the efficacy of percutaneous tibial nerve stimulation (PTNS) and transcutaneous tibial nerve stimulation (TTNS) in treating idiopathic overactive bladder (OAB). However, no study has compared the effectiveness of PTNS and TTNS added to bladder training (BT) in idiopathic OAB.
To compare the efficacy of PTNS and TTNS added to BT in women with idiopathic OAB.
We randomised 60 women with idiopathic OAB into 3 groups. Group 1 (n=19) received BT, Group 2 (n=19) received PTNS in addition to BT, and Group 3 (n=20) received TTNS in addition to BT. PTNS and TTNS were performed 2 days a week, for 30min a day, for a total of 12 sessions for 6 weeks. Patients were evaluated by incontinence severity (pad test), a 3-day voiding diary (frequency of voiding, incontinence episodes, nocturia and number of pads used), symptom severity, quality of life, treatment success (positive response rate), treatment satisfaction (Likert scale), discomfort level and preparation time for stimulation (sec).
At the end of treatment; severity of incontinence, frequency of voiding, incontinence episodes, nocturia, number of pads used, symptom severity and quality of life were significantly improved in Groups 2 and 3 versus Group 1 (P<0.0167). Treatment success and treatment satisfaction were higher in Groups 2 and 3 than Group 1 (P<0.001 and P<0.0167, respectively). Level of discomfort was lower, treatment satisfaction was higher and preparation time for stimulation was shorter in Group 3 than Group 2 (P<0.05).
Both the PTNS plus BT and TTNS plus BT were more effective than BT alone in women with idiopathic OAB. These 2 tibial nerve stimulation methods had similar clinical efficacy but with slight differences: TTNS had shorter preparation time, less discomfort level and higher patient satisfaction than PTNS.
已有不同研究报告了经皮胫神经刺激（PTNS）和经皮胫神经刺激（TTNS）治疗特发性逼尿肌过度活动症（OAB）的疗效。然而，尚无研究比较将 PTNS 和 TTNS 加入膀胱训练（BT）治疗特发性 OAB 的效果。
比较将 PTNS 和 TTNS 加入 BT 治疗特发性 OAB 的效果。
我们将 60 名特发性 OAB 女性随机分为 3 组。第 1 组（n=19）接受 BT，第 2 组（n=19）在 BT 基础上加用 PTNS，第 3 组（n=20）在 BT 基础上加用 TTNS。PTNS 和 TTNS 每周进行 2 天，每天 30 分钟，共 6 周进行 12 次。通过失禁严重程度（垫试验）、3 天排尿日记（排尿频率、失禁次数、夜尿症和使用的垫数量）、症状严重程度、生活质量、治疗效果（阳性反应率）、治疗满意度（Likert 量表）、不适程度和刺激准备时间（秒）对患者进行评估。
治疗结束时，第 2 组和第 3 组的失禁严重程度、排尿频率、失禁次数、夜尿症、垫使用数量、症状严重程度和生活质量均显著优于第 1 组（P<0.0167）。第 2 组和第 3 组的治疗效果和治疗满意度均高于第 1 组（P<0.001 和 P<0.0167）。第 3 组的不适程度较低，治疗满意度较高，刺激准备时间较短（P<0.05）。
PTNS 联合 BT 和 TTNS 联合 BT 治疗特发性 OAB 均优于单独 BT。这两种胫神经刺激方法具有相似的临床疗效，但略有不同：TTNS 比 PTNS 准备时间更短、不适程度更低、患者满意度更高。
