Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R.C China.
Medicine (Baltimore). 2022 Oct 14;101(41):e31165. doi: 10.1097/MD.0000000000031165.
The study aimed to assess the efficacy and safety of parasacral neuromodulation (PNS) versus tibial nerve stimulation (TNS) for patients with overactive bladder (OAB).
Databases including PubMed, Embase, clinicalTrial.gov, and Cochrane Library Central Register of Controlled Trials were systematically searched from January 1, 1999 to September 9, 2022. The improvements in a 3-day voiding diary were set as the primary outcomes. Then, the scores of overactive bladder-validated 8-question awareness tool (OAB-V8), King's health questionnaire (KHQ), and international consultation on incontinence questionnaire overactive bladder (ICIQ-OAB) were also evaluated.
Five articles (4 randomized controlled trials [RCTs] and 1 prospective study) including 255 OAB patients were enrolled. Two kinds of neuromodulations had similar performances in the micturition (mean difference [MD] = 0.26, 95% confidence interval [CI]: -0.51 to 1.04, P = .50), urgency episodes (MD = -0.16, 95% CI: -0.64 to 0.31, P = .50), incontinence episodes (MD = 0.09, 95% CI: -0.41 to 0.59, P = .72), as well as in the nocturia episodes (MD = 0.04, 95% CI: -0.45 to 0.52, P = .89). Furthermore, there was no difference regarding ICIQ-OAB scores (P = .83), KHQ (P = .91), and OAB-V8 scores (P = .83). Importantly, included studies reported no adverse events in the 2 groups.
TNS and PNS had similar effectiveness for the treatment of OAB, moreover, without any identified adverse events in both groups. However, well-designed RCTs are stilled needed to verify our results.
本研究旨在评估骶旁神经调节（PNS）与胫神经刺激（TNS）治疗膀胱过度活动症（OAB）患者的疗效和安全性。
系统检索了 1999 年 1 月 1 日至 2022 年 9 月 9 日期间的 PubMed、Embase、clinicalTrial.gov 和 Cochrane Library 中央对照试验注册库等数据库。以 3 天排尿日记的改善为主要结局。然后，还评估了膀胱过度活动症验证的 8 个问题意识工具（OAB-V8）、King's 健康问卷（KHQ）和国际尿失禁咨询问卷膀胱过度活动症（ICIQ-OAB）的评分。
共纳入 5 项研究（4 项随机对照试验[RCT]和 1 项前瞻性研究），包括 255 例 OAB 患者。两种神经调节方法在排尿方面的表现相似（平均差值[MD] = 0.26，95%置信区间[CI]：-0.51 至 1.04，P =.50）、急迫性事件（MD = -0.16，95%CI：-0.64 至 0.31，P =.50）、失禁事件（MD = 0.09，95%CI：-0.41 至 0.59，P =.72）以及夜尿症事件（MD = 0.04，95%CI：-0.45 至 0.52，P =.89）。此外，ICIQ-OAB 评分（P =.83）、KHQ（P =.91）和 OAB-V8 评分（P =.83）两组间无差异。重要的是，纳入的研究报告两组均无不良事件。
TNS 和 PNS 治疗 OAB 的疗效相似，而且两组均未发现任何确定的不良事件。然而，仍需要精心设计的 RCT 来验证我们的结果。
