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Zehra Kurdoğlu, Danielle Carr, Jihad Harmouche, Serdar Ünlü, Gökhan S Kılıç
OBJECTIVE: Overactive bladder (OAB) affects 16.9% of women in the United States. Percutaneous tibial nerve stimulation (PTNS) is a third-line treatment for patients who are refractory to behavioral and pharmacologic therapies. We aimed to evaluate the effects of PTNS on urinary symptoms in patients diagnosed as having refractory OAB and investigate the cost of medications and clinical visits before and after PTNS treatment. MATERIAL AND METHODS: We reviewed 60 women with refractory OAB treated with PTNS...
March 1, 2018: Journal of the Turkish German Gynecological Association
Constantinos Simillis, Nikhil Lal, Shengyang Qiu, Christos Kontovounisios, Shahnawaz Rasheed, Emile Tan, Paris P Tekkis
AIMS: Percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS) are both second-line treatments for faecal incontinence (FI). To compare the clinical outcomes and effectiveness of SNS versus PTNS for treating FI in adults. METHOD: A literature search of MEDLINE, Embase, Science Citation Index Expanded and Cochrane was performed in order to identify studies comparing SNS and PTNS for treating FI. A risk of bias assessment was performed using The Cochrane Collaboration's risk of bias tool...
February 22, 2018: International Journal of Colorectal Disease
Christopher W Elder, Paul B Yoo
Percutaneous tibial nerve stimulation (PTNS) is a clinical therapy for treating overactive bladder (OAB), where an un-insulated stainless steel needle electrode is used to target electrically the tibial nerve (TN) in the lower leg. Recent studies in anesthetized animals not only confirm that bladder-inhibitory reflexes can be evoked by stimulating the TN, but this reflex can also be evoked by stimulating the adjacent saphenous nerve (SAFN). Although cadaver studies indicate that the TN and major SAFN branch(es) overlap at the location of stimulation, the extent to which SAFN branches are co-activated is unknown...
January 31, 2018: Medical Engineering & Physics
Demetris S Soteropoulos
During everyday actions there is a need to be able to withhold movements until the most appropriate time. This motor inhibition is likely to rely on multiple cortical and subcortical areas, but the primary motor cortex (M1) is a critical component of this process. However, the mechanisms behind this inhibition are unclear, and in particular the role of the corticospinal system, which is most often associated with driving muscles and movement. In order to address this, recordings were made from identified corticospinal (PTNs, n=94) and corticomotoneuronal (CM, n=16) cells from the primary motor cortex during an instructed delay reach to grasp task...
January 3, 2018: Journal of Neurophysiology
Manuela Tutolo, Enrico Ammirati, John Heesakkers, Thomas M Kessler, Kenneth M Peters, Tina Rashid, Karl-Dietrich Sievert, Michele Spinelli, Giacomo Novara, Frank Van der Aa, Dirk De Ridder
CONTEXT: Neuromodulation is considered in patients with non-neurogenic lower urinary tract dysfunction (LUTD) not responsive to conservative treatment. OBJECTIVE: To systematically review the available studies on efficacy and safety of sacral neuromodulation (SNM) and percutaneous tibial nerve stimulation (PTNS) in non-neurogenic LUTDs not responsive to conservative treatments. EVIDENCE ACQUISITION: A literature research was conducted in PubMed/Medline and Scopus, restricted to articles in English, published between January 1998 and June 2017, with at least 20 patients and 6 mo of follow-up...
January 11, 2018: European Urology
John R Zuniga, Cyrus Mistry, Igor Tikhonov, Riham Dessouky, Avneesh Chhabra
PURPOSE: The clinical neurosensory testing (NST) is currently the reference standard for the diagnosis of traumatic and nontraumatic peripheral trigeminal neuropathies (PTNs), but exhibits both false-positive and false-negative results compared with surgical findings and frequently results in treatment decision delays. We tested the hypothesis that magnetic resonance neurography (MRN) of PTNs can serve as a diagnostic modality by correlating the NST, MRN, and surgical findings. MATERIALS AND METHODS: Sixty patients with traumatic and nontraumatic PTN of varying etiologies and Sunderland classifications underwent NST, followed by MRN using 1...
November 16, 2017: Journal of Oral and Maxillofacial Surgery
Evan R Sirls, Kim A Killinger, Judith A Boura, Kenneth M Peters
OBJECTIVE: To examine the outcomes and compliance with percutaneous tibial nerve stimulation (PTNS) for overactive bladder (OAB) symptoms. METHODS: Adults who had PTNS from June 30, 2011, to October 8, 2015, were retrospectively reviewed for demographics, copay, travel distance, employment status, history, symptoms, and treatments used before, during, and after PTNS. Pearson chi-square test, Fisher exact test, Wilcoxon rank and paired t test were performed. RESULTS: Of 113 patients (mean age 75 ± 12 years), most were women (65...
November 28, 2017: Urology
Israel Franco, Angela M Arlen, Therese Collett-Gardere, Paul F Zelkovic
INTRODUCTION AND OBJECTIVE: Lower urinary tract (LUT) and voiding dysfunction constitute a large percentage of pediatric urology referrals. Children with urinary incontinence unresponsive to behavioral modifications and traditional pharmacotherapy including anticholinergics and alpha blockers remain a challenge. We evaluated the impact of imipramine on treatment outcomes in children with refractory incontinence. STUDY DESIGN: Children ≤18 years of age with refractory non-neurogenic daytime incontinence prescribed imipramine were identified...
October 9, 2017: Journal of Pediatric Urology
Carlo Vecchioli-Scaldazza, Carolina Morosetti
PURPOSE: To assess effectiveness and durability of Solifenacin (SS) versus tibial nerve stimulation (PTNS) versus combination therapy (PTNS + SS) in women with overactive bladder syndrome (OAB). MATERIALS AND METHODS: 105 women with OAB were divided randomly into three groups of 35 patients each. In group A women received SS, in group B women underwent PTNS, in group C women underwent combination of PTNS + SS. Improvements in OAB symptoms were assessed with OABSS questionnaire; patients' quality of life was assessed with OAB-q SF questionnaire...
October 24, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
T M Kessler, S de Wachter
Neuromodulative procedures such as transcutaneous electrical nerve stimulation (TENS), transcutaneous/percutaneous tibial nerve stimulation (TTNS/PTNS), and sacral neuromodulation (SNM) are promising second-line treatments for refractory lower urinary tract dysfunction. Using these therapies, both storage and voiding disorders but also bowel dysfunction might be successfully treated. Although the mechanism of action of neuromodulation is not well understood, it seems to involve modulation of spinal cord reflexes and brain networks by peripheral afferents (genital/rectal, tibial and sacral afferents in the case of TENS, TTNS/PTNS, and SNM, respectively)...
December 2017: Der Urologe. Ausg. A
Liesbeth L de Wall, John Pfa Heesakkers
Overactive bladder syndrome (OAB) is a common condition affecting adults and children worldwide, resulting in a substantial economic and psychological burden. Percutaneous tibial nerve stimulation (PTNS) is derived from acupuncture used in Chinese traditional medicine and was first described in the early 1980s. It is a neuromodulation technique used to modulate bladder function and facilitate storage. Being a minimally invasive, easily applicable, but time-consuming treatment, future developments with implantable devices might be the solution for the logistical problems and economic burden associated with PTNS on the long term...
2017: Research and Reports in Urology
Marina Aguiar Pires Guimarães, Claudia Regina Lindgren Alves, Ana Amélia Cardoso, Márcia Gomes Penido, Lívia de Castro Magalhães
OBJECTIVE: To compare the behavior of preterm newborns (PTNs) and full-term newborns (FTNs) using the Newborn Behavioral Observation (NBO) and to evaluate the mothers' experience when participating in this observation. METHOD: This was a cross-sectional study performed at a referral hospital for high-risk births, involving mothers and neonates before hospital discharge. The mothers answered the sociodemographic questionnaire, participated in the NBO session, and evaluated the experience by answering the parents' questionnaire at the end...
August 30, 2017: Jornal de Pediatria
A A van der Wilt, G Giuliani, C Kubis, B P W van Wunnik, I Ferreira, S O Breukink, P A Lehur, F La Torre, C G M I Baeten
BACKGROUND: The aim was to assess the effects of percutaneous tibial nerve stimulation (PTNS) in the treatment of faecal incontinence (FI) by means of an RCT. METHODS: Patients aged over 18 years with FI were included in a multicentre, single-blinded RCT. The primary endpoint was reduction in the median or mean number of FI episodes per week. Secondary endpoints were changes in measures of FI severity, and disease-specific and generic quality of life. Outcomes were compared between PTNS and sham stimulation after 9 weeks of treatment...
August 2017: British Journal of Surgery
Sergío Del Río-Gonzalez, Isabel M Aragon, Elisabeth Castillo, Francisco Milla-España, Alejandro Galacho, Javier Machuca, María F Lara, Bernardo Herrera-Imbroda
OBJECTIVE: To evaluate percutaneous tibial nerve stimulation (PTNS) effectiveness, durability, and impact on the pathophysiology of overactive bladder syndrome (OAB) in patients who have been previously treated with antimuscarinics without success. MATERIALS AND METHODS: A prospective study that included 200 women diagnosed with OAB between 2007 and 2015 at Virgen de la Victoria University Hospital (Málaga, Spain) was conducted. OAB patients were treated with PTNS therapy after antimuscarinic treatment failed...
October 2017: Urology
Kaitlin Jaqua, Charles R Powell
Overactive bladder (OAB) affects millions of people around the world and decreases quality of life for those affected. Over the past two decades, significant advances in treatment have transformed the lives of those with OAB. Sacral neuromodulation (SNM), posterior tibial nerve stimulation (PTNS), and dorsal genital nerve stimulation are the most effective contemporary treatment modalities. New techniques and bio-sensing schemes offer promise to advance therapy beyond what is currently available. Current neuromodulation techniques do not use real-time data from the body or input from the patient...
August 2017: Current Urology Reports
Emma J Horrocks, Sami A Chadi, Natasha J Stevens, Steven D Wexner, Charles H Knowles
BACKGROUND & AIMS: A recent UK multicenter, phase III trial (the CONtrol of Fecal Incontinence using Distal NeuromodulaTion Trial), demonstrated no significant clinical benefit of percutaneous tibial nerve stimulation (PTNS) over sham stimulation; however, this study did not analyze predictors of response. This study aimed to determine predictors of PTNS efficacy in adults with fecal incontinence (FI) using data from this randomized controlled trial. METHODS: The study population comprised 205 patients from the CONtrol of Fecal Incontinence using Distal NeuromodulaTion Trial, with original primary outcome (≥50% reduction in weekly FI episodes after 12 weeks of treatment) remaining the binary denominator of success or failure...
June 21, 2017: Clinical Gastroenterology and Hepatology
Hammouda Sherif, Mostafa Khalil, Rabea Omar
INTRODUCTION: To compare the safety and efficacy of posterior tibial nerve stimulation (PTNS) versus an intradetrusor injection of botulinum toxin type-A (BTX-A) 100 U in the management of refractory idiopathic overactive bladder (OAB). MATERIALS AND METHODS: We randomized 60 patients with refractory idiopathic OAB to receive an intradetrusor injection of BTX-A 100 U or PTNS. We assessed the patients at baseline, 6 weeks, 3 months, 6 months, and 9 months, and determined their clinical symptoms, overall OAB symptom score, urgency score, quality-of-life score, and urodynamic study parameters...
June 2017: Canadian Journal of Urology
Zainab Moazzam, Paul B Yoo
AIMS: Percutaneous tibial nerve stimulation (PTNS) is an effective neuromodulation therapy for treating overactive bladder (OAB). The therapeutic effects are achieved by repeatedly applying electrical stimulation through a percutaneous needle electrode that is used to target the tibial nerve (TN). Anatomical studies indicate there can be multiple saphenous nerve (SAFN) branches located near the site of electrical stimulation, and therefore we investigated the possibility of evoking a bladder-inhibitory reflex by electrically activating the SAFN...
June 22, 2017: Neurourology and Urodynamics
Dick Aw Janssen, Frank Mj Martens, Liesbeth L de Wall, Hendrikje Mk van Breda, John Pfa Heesakkers
OBJECTIVES: This review describes the evidence from established and experimental therapies that use electrical nerve stimulation to treat lower urinary tract dysfunction. METHODS: Clinical studies on established treatments such as percutaneous posterior tibial nerve stimulation (P-PTNS), transcutaneous electrical nerve stimulation (TENS), sacral nerve stimulation (SNS) and sacral anterior root stimulation (SARS) are evaluated. In addition, clinical evidence from experimental therapies such as dorsal genital nerve (DGN) stimulation, pudendal nerve stimulation, magnetic nerve stimulation and ankle implants for tibial nerve stimulation are evaluated...
2017: Medical Devices: Evidence and Research
V Vigorita, S Rausei, P Troncoso Pereira, I Trostchansky, A Ruano Poblador, E Moncada Iribarren, C Facal Alvarez, A de San Ildefonso Pereira, E Casal Núñez
BACKGROUND: Low anterior resection for rectal cancer often results in severe bowel dysfunction, specifically low anterior resection syndrome (LARS), with symptoms such as incontinence, urgency, and frequent bowel movements. Percutaneous tibial nerve stimulation (PTNS) resulted in a high rate of success in patients with fecal incontinence. The aim of this study was to evaluate the effectiveness of treatment with PTNS in LARS and to identify predictors of the outcome of the technique. METHODS: The study was conducted from May 2012 to April 2015 at the Alvaro Cunqueiro Hospital, University Hospital Complex of Vigo, Spain...
April 2017: Techniques in Coloproctology
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