The effects of posterior tibial nerve stimulation on refractory overactive bladder syndrome and bladder circulation

Aim We aimed to evaluate if posterior tibial nerve stimulation (PTNS) exerts its effects on overactive bladder symptoms through changes in bladder circulation. Materials and methods Eighteen women who applied to Istanbul Medical Faculty with symptoms of urgency, frequency +/- urge incontinence and did not respond to anticholinergic treatment and behavioral modification were enrolled in the study. Weekly PTNS in 30-min sessions for 12 weeks was performed. Urogynecologic symptom assessment, 1-h pad test, bladder diary, King's Health Questionnaire (KHQ), and transvaginal Doppler ultrasonography were performed before and after treatment. Results Ten patients (55.5 %) were cured, five (27.8 %) improved, and no effect was observed in three (16.7 %). No significant change was observed in systolic and diastolic flow rate, pulsatility index, resistive index, systolic/diastolic ratio and average flow rate. Significant decrease in frequency, urgency, urge incontinence, pad test results and increase in fluid intake was observed. There was a significant improvement in physical limitations and sleeping/energy domains of KHQ. No significant change was observed in urodynamics. Conclusions PTNS does not have any effect on the bladder circulation despite positive effects on bladder diary, pad test, and quality of life in overactive bladder syndrome.