Posterior tibial nerve stimulation vs trospium chloride in treatment of overactive bladder in elderly women

Abstract

Objective This study aimed to assess the outcome of posterior tibial nerve (PTN) stimulation vs trospium chloride in the treatment of overactive bladder syndrome (OAB) in elderly women regarding safety and efficacy. Patients and methods A prospective randomized study was done on 30 postmenopausal women presented with OAB symptoms (wet or dry) in Al-Zahraa University Hospital from March 2019 to March 2020. Patients were classified into two groups. Group Ι included 15 patients who received trospium chloride. Group ΙΙ included 15 patients who were managed by percutaneous posterior tibial nerve stimulation (PTNS). The authors compared the patients in both groups for OAB symptoms (urgency, frequency, nocturia, and urge urinary incontinence) at 4, 8, and 12 weeks, and for urodynamic parameters at the beginning and the end of treatment. Results There was a statistically significant improvement regarding OAB symptoms and urodynamic parameters at the end of the treatment, with no significant difference between both groups. However, the adverse effects were observed mainly with trospium chloride group (dry mouth, constipation, and headache), which were not detected in the PTNS group. Conclusion The authors concluded that trospium chloride and PTN stimulation had the same effect in the treatment of OAB symptoms, and the two lines of treatment are effective and can be used safely in patients with OAB syndrome. However, PTNS is safe, and associated with significant improvement of OAB symptoms, with no significant adverse effect in comparison with trospium chloride, which led to discontinuation of treatment. However, initial studies showed promise. A more comprehensive evaluation of PTNS is needed to support its universal use for the treatment of OAB syndrome.