Peripheral afferent nerve stimulation for treatment of lower urinary tract irritative symptoms

Objectives: To assess the efficacy of posterior tibial nerve stimulation for treatment of lower urinary tract irritative symptoms (urgency, frequency, urge incontinence and pelvic pain). Patients and Methods: 51 female patients with a mean age of 55 years were enrolled in the study. The patients presented with the following symptoms: Frequency/urgency 26 patients (50.98%), urge incontinence 22 (43.13%) and interstitial cystitis 3 patients (5.88%). The technique consists in administering low voltage electric stimulation via a 3-5 cm needle placed above the tibial malleolus. Patients received weekly stimulations of 30 minutes for a 10-week period. Quality of life questionnaires and voiding diaries before and after treatment were completed. Moreover, the results were evaluated by patients. The variables analysed include: daytime and nighttime voiding frequency, daytime and nighttime voiding volume, daytime and nighttime leakage episodes and hypogastric pain. Results: A statistically significant improvement was seen in all variables, especially remarkable in relation to frequency/urgency, impact on women quality of life and hypogastric pain, being less marked in relation to leakage episodes and voiding volume. Conclusions: Afferent nerve stimulation offers an alternative treatment for managing lower urinary tract irritative symptoms. However, it would be advisable to confirm the results obtained by means of long-term randomized, follow-up studies. (C) 2003 Elsevier B.V. All rights reserved.