Presentation Authors: Manon te Dorsthorst*, Arnhem , Netherlands, Michael van Balken, Arnhem, Netherlands
Introduction: Percutaneous Tibial Nerve Stimulation (PTNS) is a form of minimal invasive neuromodulation. Usually it is used in the treatment of overactive bladder (OAB). PTNS reduces complaints of OAB by 60-80%. However patients do need maintenance treatment with PTNS. Real life data are rare in literature as is long-term follow-up.
Methods: In this retrospective study we included all patients who underwent PTNS from January 2008 till July 2018 in our center. Data were extracted from patient files. We analyzed indication for starting treatment with PTNS, moment/reason of discontinuing of PTNS and next line of treatment after PTNS. Kaplan-Meier curves were used to calculate &[Prime]survival&[Prime] of the treatment. Results of treatment were evaluated for 4 groups. Group A: all patients. Group B: all patients who continued PTNS after 12 weeks. Group C: patients with maintenance PTNS minus patients with initial good response who however quitted because of death, moving, successfully switch to TENS or without any problems of OAB after treatment. Group D: group C minus patients with initial good response but who have quitted their treatment because of physical strain or problems visiting the hospital.
Results: In total we included 402 patients. Baseline criteria were as follows: 70% female, median age was 70 years (SD 15). Mostly indication for starting PTNS was OAB-wet (54%) or OAB- dry (29%). Median follow up (mFU) of the total group was 4 months (Fig. 1A, maximum follow up 112 months). 228 Patients (57%) continued treatment after 12 weeks (Fig. 1B). In group C 48 Patients discontinued PTNS (Fig. 1C, mFU18 months). Group D has a mFU of 46 months (Fig. 1D). Patients who quitted during maintenance PTNS mostly choose Botox (14%) or Mirabegron (10%) as next line of treatment in OAB, or nothing (57%).
Conclusions: Our real life data show comparative percentages of success in the treatment of OAB by PTNS compared to former published data. This study with a follow up of over 10 years shows that PTNS is also successful on the long term. Development of an implant for replacing percutaneous treatment could even be more successful as some patients stopped because of physical strain or too many visits.