Our 11 Year Experience with Percutaneous Tibial Nerve Stimulation (PTNS) in Men and Women for the Treatment of Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) - Beyond the Abstract
A: IC/BPS stands for Interstitial cystitis/bladder pain syndrome (IC/BPS), which is defined as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes”.
Q: Can you explain the background of IC/BPS and its treatment options?
A: IC/BPS is characterized by urinary bladder discomfort lasting more than six weeks without an identifiable cause. Treatments include medications like pentosan polysulfate sodium and procedures such as intradetrusor botulinum toxin A chemodenervation (BTA), percutaneous tibial nerve stimulation (PTNS) and sacral neuromodulation (SNM).
Q: Why was PTNS considered as a treatment option for IC/BPS?
A: PTNS has shown success in treating overactive bladder (OAB) and shares symptoms with IC/BPS. Given its effectiveness in OAB and the overlap in symptoms, PTNS was investigated as a potential treatment for IC/BPS.
Q: How was the study conducted?
A: The study involved a retrospective chart review of 34 IC/BPS patients who underwent PTNS from January 2010 to October 2021. Patients with at least 10 weekly PTNS sessions were included, and outcomes were analyzed based on conversion to maintenance therapy and symptom improvements.
Q: What was the objective of the study?
A: The objective was to evaluate the effectiveness of percutaneous tibial nerve stimulation (PTNS) in treating interstitial cystitis/bladder pain syndrome (IC/BPS).
Q: What were the key findings of the study?
A: Out of 34 patients who completed 12 weeks of PTNS therapy, 48.1% successfully transitioned to maintenance therapy. Significant improvements were observed in the urgency severity scale and nocturnal urinary frequency, while improvements in daytime void frequency and pain domain of the interstitial cystitis symptoms index were not statistically significant.
Q: Did the presence of psychiatric diagnoses or diabetes affect PTNS outcomes?
A: There was no statistically significant difference in PTNS outcomes between patients with and without psychiatric diagnoses or diabetes.
Q: What is the significance of these findings?
A: Despite nonsignificant improvements in pain and daytime void frequency, the study suggests that PTNS could be a viable option in the comprehensive management of IC/BPS, especially due to its significant improvements in urinary urgency and nocturia.
Q: What are the notable aspects of this study?
A: This study represents one of the largest samples of PTNS in IC/BPS from a single center, providing valuable insights into the potential benefits of PTNS therapy in this patient population.
Written by: Abdelrahman Sherif Abdalla, MD, Department of Medicine, AdventHealth, Sebring, Florida
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