The role of Percutaneous posterıor tıbıal nerve stımulatıon (PTNS) eıther alone or combıned wıth an antıcholınergıc agent ın the treatment of patıents wıth overactıve bladder

In the present study, it was aimed to evaluate the efficacy of Percutaneous Tibial Nerve Stimulation (PTNS) either alone or combined with an anticholinergic in the treatment of patients with overactive bladder (OAB) in whom conservative treatments failed previously.Between January 2010 and April 2011, a total of 30 volunteered patients presented with lower urinary system symptoms and diagnosed as OAB after clinical investigations were included into the study. The treatment was administered to the patients having symptoms of OAB (urgency, urge incontinence, nocturia, frequent urination) for at least 6 months and to the patients who failed to respond to previous therapies and/or discontinued because of side effects. Patients were randomly divided into 3 groups (n=10). Group I: PTNS group, Group II: patients receiving anticholinergic, Group III: Patients receiving both PTNS and anticholinergic. PTNS, treatment continued for 10 weeks with each session of 30 minutes.Bladder diaries of patients after the treatment were compared to pre-treatment period in all patients and there was significant improvement in all parameters of diaries (amount of urine outflow, frequency in daytime, nocturia, urge incontinence, urgency) in all 3 groups (p<0.05). Similarly, all scores measured by questionnaires (UDI-6, IIQ-7 and OABSS) showed significant improvement in all groups. In comparison of the improvement in symptoms among the groups, there was statistically significantly higher improvement in PTNS and PTNS+AKK groups than group II.In the present study, it was determined that PTNS is a safe, simple and minimal invasive treatment modality in patients with OAB. It had no significant side effects and was effective in the short-term. This method was found to be more effective than anticholinergics in the treatment of resistant OAB cases and it may be suggested either alone or in combination with anticholinergics in patients with previously failed treatments.Key Words: Overactive Bladder, Treatment, Percutaneous Tibial Nerve Stimulation, Anticholinergic.