Factors associated with overactive bladder symptoms improvement after one year of monthly PTNS treatment
IUGA Academy. Rostaminia G. Jun 30, 2018; 212880; 453 Topic: Overactive Bladder
Ghazaleh Rostaminia
Ghazaleh Rostaminia

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Factors associated with overactive bladder symptoms improvement after one year of monthly PTNS treatment

Rostami Nia, G1; Lozo, S1; Botros , C1; Sand, P1; Goldberg, R1

1: NorthShore HealthSystem University/ University of Chicago

Introduction: It has been shown that maintenance Posterior Tibial Nerve Stimulation (PTNS) treatments are necessary for patients with over active bladder symptoms (OAB) who are successfully treated after 12 weekly PTNS sessions. They have a subjective and objective deterioration in their complaints when it is not provided.

Objective: To investigate patient characteristics that are associated with OAB symptom change after 12 monthly PTNS treatments.

Methods: This was a retrospective chart review of women who underwent PTNS for OAB from Jan 2011- Dec 2017 and had completed 12 monthly sessions following 12 weekly sessions. The patient’s age, BMI, parity, medical and surgical history, urodynamic study variables and duration of OAB symptoms were collected from patients’ electronic medical records. Treatment outcome was evaluated by the subjective improvement per patient’s report as percentage and bladder diary improvement by comparing the intervoiding interval, nocturia episodes and urgency urinary incontinence episodes/day before and after treatment as objective improve. The percentage improvement from baseline was also recorded. Baseline symptoms were dichotomized for each symptom based on their severity. Continuous variables were summarized as means with their standard deviation. Categorical variables were summarized as frequencies and percentages. Paired t-test were used to evaluate the change from baseline to the end of the study for each patient. T-tests and chi-squared tests were used to assess the group differences from baseline to the end of the study. Multivariable regression was utilized to identify significant predictors of subjective outcomes.

Results: 66 patients were recruited to the trial. Demographic data is summarized in Table1. Average subjective improvement after 12 monthly session was 5.2% +- 15.5. Table 2 summarizes symptom improvement after 12 weekly and 12 monthly sessions. There was a weak correlation between subjective improvement and improvement in urinary frequency (r =0.4, P =0.004). We dichotomized the cohort into 2 groups based on subjective improvement of ≤ 0% and > 0% and used multivariable regression analysis to identify prognostic factors for symptom improvement. BMI, neurological disease, H/O prolapse or incontinence surgery, and a history of onabotulinumtoxinA injection were significant predictors of subjective improvement. Those who didn't have pelvic floor reconstructive surgery or onabotulinumtoxinA injections were more likely to have subjective improvement after 12 monthly PTNS sessions. Women with higher BMI or neurological disease were more likely to have subjective improvement in their OAB.

Conclusions: Subjective and objective improvement of symptoms after one year of monthly PTNS treatments was minimal. A history of pelvic floor reconstructive surgery and intravesical onabotulinumtoxinA injection were negative predictors of subjective symptom improvement. A history of neurological disease was positive predictive of subjective improvement after one year of monthly PTNS treatment.


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