Percutaneous tibial nerve stimulation maintenance therapy for overactive bladder in women: long-term success rates and adherence

Purpose Our objectives are to (1) identify predictors of treatment success in women with overactive bladder (OAB) after 1 year of percutaneous tibial nerve stimulation (PTNS) maintenance therapy, (2) identify trends in success rates during that 1 year, and (3) assess maintenance treatment adherence. Materials and methods A retrospective study of 141 women with OAB was performed with the definition of success based on a Patient Global Impression-Improvement (PGI-I) score of 1 (very much better) or 2 (much better) or a PGI-I score of 1, 2, or 3 (a little better). Multivariable logistic regression was performed to identify factors associated with treatment response and the Cochrane-Armitage trend test to identify changes in the scores over time. Results After completing 12 weekly treatments, 141 women initiated maintenance therapy with a mean treatment interval of 29 days. At 1 year, 75/141 (53.2%) had discontinued treatment. Those adherent with treatment had a sustained treatment response, with 66.2% of women reporting a PGI-I score of 1, 2 and 92.3% reporting a PGI-I score of 1, 2, or 3 at 1 year. Considering those women who discontinued maintenance therapy as treatment failures, the success rate of 1 year of maintenance therapy ranged from 30.7%-42.9%. No clinical factors were found to be predictive of maintenance treatment success or failure. Conclusions Although an effective treatment for those adherent, discontinuation rates of PTNS maintenance therapy at 1 year are high. Given the low numbers of women referred to maintenance therapy, and the high discontinuation rates, long-term PTNS treatment may be feasible for only a minority of women with OAB.

Automated summary

The study aimed to identify predictors of treatment success in women with OAB undergoing PTNS maintenance therapy, assess treatment adherence, and trends in success rates. At 1 year, 53.2% of patients had discontinued treatment, with a success rate ranging from 30.7%-42.9%. No clinical factors were predictive of maintenance treatment success or failure. High discontinuation rates suggest long-term PTNS may only be feasible for a minority of women with OAB.