Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, 20160, Denizli, Turkey.
Int Urogynecol J. 2024 Mar;35(3):571-578. doi: 10.1007/s00192-023-05704-0. Epub 2024 Jan 11.
The aim of this study is to compare the effectiveness of transcutaneous tibial nerve stimulation (TTNS) on quality of life (QoL) and clinical parameters related to incontinence in pharmacological agents (PhAs) naive and refractory women with idiopathic overactive bladder (iOAB).
In this prospective nonrandomized clinical trial, women with resistance to PhAs were included in the first group (n=21), PhA-naive women were included in the second group (n=21). TTNS was performed 2 days a week, a total of 12 sessions for 6 weeks. Every session lasted 30 min. Women were evaluated for the severity of incontinence (Pad test), 3-day voiding diary (voiding frequency, nocturia, incontinence episodes, and number of pads), symptom severity (Overactive Bladder Questionnaire-V8), quality of life (Incontinence Impact Questionnaire-7), treatment satisfaction, positive response, and cure-improvement rates.
A statistically significant improvement was found in all parameters for each group at the 6th week compared with the baseline values (p<0.05). It was found that the severity of incontinence, incontinence episodes, symptom severity, treatment satisfaction, and QoL parameters were significantly improved in PhA-naive group compared with the PhA-resistant group at the 6th week (p<0.05). There were no statistically significant differences in the frequency of voiding, nocturia, and number of pads between the two groups (p>0.05). Positive response rates, the primary outcome measure, were statistically significantly higher in the PhA-naive group than in the PhA-resistant group.
Although TTNS is more effective in PhA-naive women with iOAB, it appears to be an effective therapy that can also be used in the management of PhA-resistant women with iOAB.
本研究旨在比较经皮胫神经刺激（TTNS）对药物治疗初治和难治的特发性逼尿症（iOAB）女性生活质量（QoL）和与失禁相关的临床参数的疗效。
在这项前瞻性非随机临床试验中，将对药物治疗有抵抗的女性纳入第一组（n=21），将药物治疗初治的女性纳入第二组（n=21）。TTNS 每周进行 2 天，共进行 6 周 12 次治疗。每次治疗持续 30 分钟。使用垫试验评估失禁严重程度，3 天排尿日记（排尿频率、夜尿、失禁次数和尿垫数量），症状严重程度（膀胱过度活动症问卷-V8），生活质量（失禁影响问卷-7），治疗满意度，阳性反应和治愈率改善率。
与基线值相比，每组在第 6 周时所有参数均有统计学显著改善（p<0.05）。与药物治疗抵抗组相比，药物治疗初治组在第 6 周时，失禁严重程度、失禁次数、症状严重程度、治疗满意度和 QoL 参数均显著改善（p<0.05）。两组之间排尿频率、夜尿和尿垫数量无统计学显著差异（p>0.05）。主要结局指标阳性反应率在药物治疗初治组明显高于药物治疗抵抗组。
尽管 TTNS 对药物治疗初治的 iOAB 女性更有效，但它似乎是一种有效的治疗方法，也可用于管理药物治疗抵抗的 iOAB 女性。
