https://www.ijmhr.org/ijpr.html editor_physiotherapy@hotmail.com
ISSN:       2321-1822 (E) 2321-8975 (P)

IJPR.2017.196

DOWNLOAD PDF
Table of Contents

Type of Article:  Original Research

Volume 5; Issue 5 (September 2017)

Page No.: 2306-2313

DOI: https://dx.doi.org/10.16965/ijpr.2017.196

URODYNAMIC EFFECT OF PERCUTANEOUS POSTERIOR TIBIAL NERVE STIMULATION FOR URINARY INCONTINENCE IN PARAPARETIC PATIENTS

Yasser lbrahim Seada 1, Bassam Abdelmageed Elnassag 2, Waleed Talat Mansour 3, Mohamad Saeid Tawfik 4.

1 Assistant Professor, Faculty of Physical Therapy, Cairo University, Egypt.

2 Lecturer, Faculty of Physical Therapy, Cairo University, Egypt.

3 Professor, Faculty of Physical Therapy, Cairo University, Egypt.

4 Assistant Professor, Faculty of Medicine, Zagazig University. Faculty of Medicine, Najran University, Saudi Arabia.

Corresponding Author: Dr. Bassam A. Elnassag, Lecturer, Faculty of Physical Therapy, Cairo University, 7 Ahmed El-Zayat Street, Dokki, Giza, Egypt. E-Mail: drbassam_2000@yahoo.com

ABSTRACT

Background: Urinary incontinence is one of the most inconvenient problems in patients with spinal cord injury. This study was done to evaluate the effectiveness of Percutaneous Posterior Tibial Nerve Stimulation (PPTNS) in treatment of urinary incontinence in patients with dorsal level (T7-T12) Paraparesis.

Materials and Methods: This study was a randomized controlled study included 30 traumatic paraparetic patients of both sexes. They were randomly divided into two equal groups: Group I (GI) was a control group treated by physical therapy program for bladder training and placebo PPTNS. Group II (GII) was an experimental group treated by the same physical therapy program in addition to real PPTNS. All patients received the treatment program for 40 minutes, three days/week day after day for 12 weeks. All patients were assessed before initiating conservative treatment and after the end of treatment program by: Electromyographic measurement for detrusor and pelvic floor muscles’ activity, urine testing by cystometry and bladder residual volume measurement.

Results: There was a statistically significant improvement in GII than GI, regarding all variables (P <0.001).

Conclusion: PPTNS is an effective method in treating urinary incontinence in paraparetic patients and considered as a treatment modality filling the gap between conservative and surgical therapies in patients with certain types of urinary incontinence.

Key words: Percutaneous Posterior Tibial Nerve Stimulation, Cystometry, Electromyography, Urinary Incontinence, Paraparesis.

REFERENCES

  1. Cruz CD, Cruz F. Spinal cord injury and bladder dysfunction: new ideas about an old problem. Scientific World Journal 2011;11:214–34.
  2. Guy P and Grundy D. Urological management. In: Grundy D, Swain A. ABC of spinal cord injury. 4th ed. BMJ Books; 2002. 33.
  3. Abrams P, Cardozo L, Fall M., Rosier P and Ulmsten U. The standardization of terminology of lower urinary tract function: report from the Standardization Subcommittee of the International Continence society. Neurourol Urodyn 2002; 21(2):167-78.
  4. Ronald GS, Beth KY, Arthur HF and Ingrid NE: Danforth’s obstetrics and gynecology (10 ed.) Philadelphia: Lippincott Williams & Wilkins; 2008: Pp. 890-891. ISBN 9780781769372.
  5. Burgio KL, Goode PS, Locher JL, Umlauf MG and Roth DL, Richter HE et al. Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial. JAMA 2002; 288(18):2293-9.
  6. Harvey MA. Pelvic floor exercises during and after pregnancy: A systematic review of their role in preventing pelvic floor dysfunction. Journal of Obstetrics and Gynaecology Canada 2003;25(6):487-98.
  7. Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol 2012;188 (6 Suppl):2455-63.
  8. Yoong W, Ridout AE, Damodaram M and Dadswell R. Neuromodulative treatment with percutaneous tibial nerve stimulation for intractable detrusor instability: outcomes following a shortened 6-week protocol. BJU Int 2010; 106(11):1673-6.
  9. Danisman A, Kutlu O and Akkaya E et al. Tibial nerve stimulation diminishes mast cell infiltration in the bladder wall induced by interstitial cystitis urine. Scand J Urol Nephrol 2007;41(2):98–102.
  10. National Institute for Health and Clinical Excellence (NICE). Percutaneous tibial nerve stimulation for overactive bladder symptoms. 2010. http://www.nice.org.uk/nicemedia/live/12412/51304/51304.pdf.
  11. Staskin DR, Peters KM, MacDiarmid S, Shore N, de Groat WC. Percutaneous Tibial Nerve Stimulation: A Clinically and Cost Effective Addition to the Overactive Bladder Algorithm of Care. CurrUrol Rep 2012;13:327–334. DOI 10.1007/s11934-012-0274-9.
  12. Peters KM, Carrico DJ, Perez-Marrero RA, Khan AU, Wooldridge LS, Davis GL, et al. Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol 2010;183(4):1438–43. doi: 10.1016/j.juro.2009.12.036.
  13. Hegazy AS, Abu Ghareeb ME, Kamal KM, Ashour A. Comparative Study between the Efficacy of Percutaneous Posterior Tibial Nerve Stimulation (PTNS) versus Propiverine Hydrochloride for the Treatment of the Overactive Bladder. Ain Shams Medical Journal 2014;65(1-3):197-202.
  14. Kabay SC, Kabay S, Mestan E, Cetiner M, Ayas S, Sevim M, Ozden H, Karaman HO. Long term sustained therapeutic effects of percutaneous posterior tibial nerve stimulation treatment of neurogenic overactive bladder in multiple sclerosis patients: 12-months results. Neurourology and Urodynamics 2017;36:104–110.
  15. Rathore MFA. Spinal cord injuries in the developing world. In: JH Stone, M Blouin, eds. International Encyclopedia of Rehabilitation, 2013. Available online: http://cirrie.buffalo.edu/ encyclopedia/en/article/141/.
  16. World Health Organization (WHO). International perspectives on spinal cord injury. World Health Organization; 2013. Available at:  http://apps.who.int/iris/bitstream/10665/94190/1/9789241564663_eng.pdf.
  17. Tator CH. Current primary to tertiary prevention of spinal cord injury. Top Spinal Cord Inj Rehabil 2004;10:1–14.
  18. Kabay SC, Kabay S, Mestan E, Cetiner M, Ayas S, Sevim M, Ozden H, Karaman HO. Long term sustained therapeutic effects of percutaneous posterior tibial nerve stimulation treatment of neurogenic overactive bladder in multiple sclerosis patients: 12-months results. Neurourology and Urodynamics 2017; 36:104–110.
  19. Krhut J, Zachoval R, Rosier P F.W.M, Shelly B, Zvara P. Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults. Neurourology and Urodynamics 2017;9999:1–6.
  20. Kinder MV, van Waalwijk ESC, Gommer ED, and Janknegt RA. A non-invasive method for bladder electromyography in humans.  Archives of Physiology and Biochemistry 1998;106:2-11.
  21. Bellette PO, Rodrigues-Palma PC, Hermann V, Riccetto C, Bigozzi M, Olivares JM. Posterior tibial nerve stimulation in the management of over active bladder: A prospective and controlled study. ACTAS UROLÓGICAS ESPAÑOLAS 2009;33(1):58-63.
  22. Alhasso A.A., McKinlay J., Patrick K. and Stewart L. Anticholinergic drugs versus non-drug active therapies for overactive bladder syndrome in adults. Cochrane Database Syst Rev 2006;4:CD003193.
  23. Dmochowski R.R. and Omelsky A. Update on the treatment of overactive bladder. CurrOpin Urol 2011;21(4):286-290.
  24. Peters KM, MacDiarmid SA, Wooldridge LS, et al: Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol 2009;182(3):1055–1061.
  25. Wooldridge LS. Percutaneous tibial nerve stimulation for the treatment of urinary frequency, urinary urgency, and urge incontinence: results from a community-based clinic. Urol Nurs 2009;29(3):177-185.
  26. Finazzi-Agro E, Petta F, Sciobica F, Pasqualetti P, Musco S, Bove P. Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, double-blind, placebo controlled trial. J Urol 2010;184(5):2001–6. doi: 10.1016/j.juro.2010.06.113.
  27. Vandoninck V, Balken MR, Finazzi Agro E, Petta F, Micali F, Heesakkers JP, et al. Percutaneous tibial nerve stimulation in the treatment of overactive bladder: urodynamic data. Neurourol Urodyn 2003;22(3):227–32. doi: 10.1002/nau.10111.
  28. Matzel K, Hohenfellner M. and Hohenberger W. Chronic Sacral Nerve Stimulation for Faecal Incontinence: Long- term Results with Foramen and Cuff Electrodes. Dis Colon Rectum 2001;44:59-66.
  29. McGuire E.J., Zhang S.C., Horwinski E.R. and Lytton B.: Treatment of motor and sensory detrusor instability by electrical stimulation. J Urol 1983;129:78-9.
  30. Van der Pal F., van Balken M.R., Heesakkers J.P., Debruyne F.M. and Bemelmans B.L.:Percutaneoustibial nerve stimulation in the treatment of refractory overactive bladder syndrome: is maintenance treatment necessary? BJU Int 2006;97:547-50.
  31. Nygard I. and Holcomb R. Reproducibility of seven-day voiding diary in women with stress urinary incontinence. IntUrogynecol J Pelvic Floor Dys Funct 2000;11:15-7.
  32. Tai C, Shen B, Chen M, Wang J, Roppolo JR, de Groat WC. Prolonged poststimulation inhibition of bladder activity induced by tibial nerve stimulation in cats. Am J Physiol Ren Physiol 2011;300(2):F385–92. doi:10.1152/ajprenal.00526.2010.
  33. Choudhary M, van Mastrigt R, van Asselt E. Inhibitory effects of tibial nerve stimulation on bladder neurophysiology in rats. Springerplus 2016; 5:35.
  34. Sheldon R, Kiff E, Clarke A, Harris M, Hamdy S. Sacral nerve stimulation reduces corticoanal excitability in patients with faecal incontinence. Br J surg 2005; 92(11):1423-1431.
  35. Blok BF, Groen J, Bosch J, Veltman DJ, Lammertsma AA. Different brain effects during chronic and acute sacral neuromodulation in urge incontinent patients with implanted neurostimulators. BJU Int 2006;98(6):1238-1243.
  36. Matsuta Y, Mally AD, Zhang F, et al. Contribution of opioid and metabotropic glutamate receptor mechanisms to inhibition of bladder overactivity by tibial nerve stimulation. Am J Physiol Regul Integr Comp Physiol 2013; 305(2):R126-133.
  37. Finazzi-Agrò E, Rocchi C, Pachatz C, et al. Percutaneous tibial nerve stimulation produces effects on brain activity: study on the modifications of the long latency somatosensory evoked potentials. NeurourolUrodyn 2009; 28(4):320–324.
  38. Zhao J and Nordling J. Posterior tibial nerve stimulation in patients with intractable interstitial cystitis. BJU Int 2004; 94: 101–104.
  39. Fjorback ML, van Rey FS, van derpal F. Acute urodynamic effect of posterior tibial nerve stimulation on neurogenic detrusal over activity in patients with MS. Eur. Uro 2006; 51: 464-470.

Cite this article: Yasser lbrahim Seada, Bassam Abdelmageed Elnassag, Waleed Talat Mansour, Mohamad Saeid Tawfik. URODYNAMIC EFFECT OF PERCUTANEOUS POSTERIOR TIBIAL NERVE STIMULATION FOR URINARY INCONTINENCE IN PARAPARETIC PATIENTS. Int J Physiother Res 2017;5(5):2306-2313. DOI: 10.16965/ijpr.2017.196
Post Views: 0