Sirls ER, et al. - This study was planned to assess the outcomes and compliance with percutaneous tibial nerve stimulation (PTNS) for overactive bladder symptoms (OAB). Researchers observed that most patients improved after weekly PTNS. However, non-adherence to maintenance and lack of efficacy could limit long term feasibility. Non-compliance seemed to have no association with co-pay and distance traveled.

Methods

• From 6/30/2011 to 10/8/2015, a retrospective review of adults that had PTNS was performed for demographics, co-pay, travel distance, employment status, history, symptoms, and treatments used before, during and after PTNS.
• They performed Pearson's Chi-square, Fisher's exact, Wilcoxon rank and paired t tests.

Results

• This study included 113 patients (mean age 75 ± 12 years); majority of them were women (65.5%), married (78.1%), and retired/unemployed (80.2%).
• Researchers noticed that median distance to the clinic was 8.1 miles, and the median co-pay was $0.
• Nocturia (92.9%) was identified as the most common indication for PTNS followed by OAB with urgency urinary incontinence (75.2%), and urinary urgency/frequency (24.8%).
• Anticholinergics (75.2%), mirabegron (36.6%), behavioral modification (29.2%), pelvic floor physical therapy (18.6%) and others (19.5%) were recognized as the previous treatments received.
• A mean of 10.5 ± 3 of 12 planned weekly PTNS treatments was completed by the patients.
• Forty (38.1%) of 105 (38.1%) patients were receiving concomitant treatments (most commonly anticholinergics).
• Improvement was observed in 62/87 (71.3%) patients at 6 weeks and 60/85 (70.6%) patients at 12 weeks.
• All 12 weekly treatments were completed by the majority (82; 75.6%) of the patients; 45 (54.9%) completed 3 (median) monthly maintenance treatments.
• Lack of efficacy was the most common reason for non-compliance.
• No association of visit co-pay, employment status, and distance to clinic with failure to complete weekly treatments or progressing to monthly maintenance was observed.