College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Int J Urol. 2022 Oct;29(10):1170-1180. doi: 10.1111/iju.14961. Epub 2022 Jun 16.
Overactive bladder (OAB) is identified as a urinary urgency accompanied by frequency and nocturia with or without urgency urinary incontinence in the nonexistence of a urinary tract infection or other evident pathologies. This systematic review and meta-analysis aimed to evaluate the efficacy of the transcutaneous tibial nerve stimulation (TTNS) versus percutaneous tibial nerve stimulation (PTNS) or anticholinergic drugs in reducing symptoms and improving the quality of life for OAB patients.
We performed a systematic search in Medline, Embase, and CENTRAL, in which we included randomized controlled trials that compared TTNS with anticholinergic drugs or PTNS in treating idiopathic OAB. We evaluated the following outcomes: 3-day voiding diary (voiding frequency/day, daytime micturition frequency/day, nighttime micturition frequency/day, number of urgency episodes/day, number of incontinence episodes/day, and mean voiding volume), symptom bother, health related quality of life (HRQoL), and adverse events. We used 95% as a confidence interval (CI) and p < 0.05. Standardized mean difference (SMD) was used for continuous outcomes, and the risk ratio (RR) was used for dichotomous outcomes.
There was no significant difference comparing TTNS with anticholinergic drugs or PTNS regarding voiding frequency/day (SMD = -0.01, 95% CI -0.33 to 0.32), nighttime micturition frequency/day (SMD = -0.28, 95% CI -0.94 to 0.37), number of urgency episodes/day (SMD = -0.05, 95% CI -0.36 to 0.26), number of incontinence episodes/day (SMD = -0.04, 95% CI -0.32 to 0.25), symptom bother (SMD = -0.19, 95% CI -0.55 to 0.16), HRQoL (SMD = 0.27, 95% CI -0.32 to 0.85), and adverse events (RR = 0.07, 95% CI 0.01 to 0.54).
The current meta-analysis reveals that there is no statistically significant difference between TTNS versus PTNS or anticholinergic drugs for the nonsurgical management of OAB patients.
膀胱过度活动症（OAB）被定义为一种在不存在尿路感染或其他明显病理的情况下出现的伴有尿急、尿频和夜尿的尿失禁。本系统评价和荟萃分析旨在评估经皮胫神经刺激（TTNS）与经皮胫神经刺激（PTNS）或抗胆碱能药物相比，在减轻 OAB 患者症状和改善生活质量方面的疗效。
我们在 Medline、Embase 和 CENTRAL 中进行了系统搜索，纳入了比较 TTNS 与抗胆碱能药物或 PTNS 治疗特发性 OAB 的随机对照试验。我们评估了以下结局：3 天排尿日记（排尿频率/天、白天排尿频率/天、夜间排尿频率/天、尿急发作次数/天、尿失禁发作次数/天和平均排尿量）、症状困扰、健康相关生活质量（HRQoL）和不良事件。我们使用 95%置信区间（CI）和 p<0.05。连续结局采用标准化均数差（SMD），二分类结局采用风险比（RR）。
与抗胆碱能药物或 PTNS 相比，TTNS 在排尿频率/天（SMD=-0.01，95%CI-0.33 至 0.32）、夜间排尿频率/天（SMD=-0.28，95%CI-0.94 至 0.37）、尿急发作次数/天（SMD=-0.05，95%CI-0.36 至 0.26）、尿失禁发作次数/天（SMD=-0.04，95%CI-0.32 至 0.25）、症状困扰（SMD=-0.19，95%CI-0.55 至 0.16）、HRQoL（SMD=0.27，95%CI-0.32 至 0.85）和不良事件（RR=0.07，95%CI 0.01 至 0.54）方面无统计学差异。
本荟萃分析显示，在 OAB 患者的非手术治疗中，TTNS 与 PTNS 或抗胆碱能药物相比，无统计学意义上的差异。
