Transcutaneous tibial nerve stimulation to treat urgency urinary incontinence in older women: 12-month follow-up of a ra
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ORIGINAL ARTICLE
Transcutaneous tibial nerve stimulation to treat urgency urinary incontinence in older women: 12-month follow-up of a randomized controlled trial Lucas Schreiner 1 & Christiana Campani Nygaard 1,2 Irênio Gomes da Silva Filho 3
&
Thais Guimarães dos Santos 1 & Mara Regina Knorst 1 &
Received: 30 April 2020 / Accepted: 2 October 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis Urgency urinary incontinence (UUI) is highly prevalent in elderly individuals and has a great impact on quality of life. Transcutaneous tibial nerve stimulation (TTNS) can be an effective treatment option for UUI in older women. Methods This is a single-center randomized clinical trial with a 12-month follow-up involving 106 women > 60 years of age. Kegel exercises and bladder retraining were performed alone or in combination with TTNS, which consisted of using a transcutaneous electrical nerve stimulator for 30 min once a week for 12 weeks with the following settings: continuous mode, 10 Hz, 200 ms, and 10 to 50 mA (according to hallux mobilization). Responders to therapy who experienced failure during follow-up were invited for a 3-week protocol with the same parameters as those used for the initial therapy. Patients were evaluated at baseline, 4 weeks after the 12-week protocol, and every 3 months for 12 months, through subjective satisfaction questionnaires, a 3-day bladder diary and the International Consultation on Incontinence Questionnaire-Short Form. King’s Health Questionnaire was applied pretreatment and 4 weeks after the last session of the 12-week protocol. Results A total of 101 women completed the initial 12-week protocol. TTNS patients reported 66.7% subjective global satisfaction vs. 32.0% in the control group (p < 0.001). The TTNS group showed statistically significant improvement in quality of life (QoL) and UUI parameters compared with the control group. Forty-eight patients were satisfied after the 12-week protocol and completed the 12-month follow-up (32 in the TTNS group and 16 in the control group). A total of 80.5% of responders to TTNS were still satisfied at the end of the 12-month follow-up vs. 30.8% in the control group (p = 0.009). Conclusion TTNS is effective at the 12-month follow-up for the treatment of UUI in elderly women. Keywords Urgency urinary incontinence . Elderly . Electrical stimulation
Introduction * Christiana Campani Nygaard [email protected] 1
Gynecology Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
2
Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, Dorking Rd, Epsom KT18 7EG, UK
3
Neurology Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
The prevalence of urgency urinary incontinence (UUI) increases throughout life. Several therapeutic options are available to manage urinary incontinence in elderly individuals [1, 2]. Electrical stimulation with nonimplanted devices is one therapeutic alternative
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