Outcomes in female idiopathic UUI better with EPNS than with transvaginal stimulation


Electrical pudendal nerve stimulation (EPNS) may be a better treatment approach than transvaginal electrical stimulation (TES) for drug-refractory female idiopathic urgency urinary incontinence (UUI), a study suggests.

A total of 120 patients with UUI were randomized to receive either EPNS (n=80) or TES (n=40). The EPNS intervention was delivered by deeply inserting electrified acupuncture needles into four sacrococcygeal points to stimulate the pudendal nerves.

The outcomes of interest included a 24-hour pad test and a questionnaire to measure the severity of symptoms and quality of life (UUI total score).

The UUI total score decreased from 13 at baseline to 2 at treatment conclusion in the EPNS group and from 11 to 6.5 in the TES group. The between-group difference in post-treatment UUI total score achieved significance (p<0.01).

Complete symptom resolution occurred in 42.5 percent of EPNS-treated patients vs 2.5 percent of TES-treated patients. The 50 percent symptom improvement rates were 70.1 and 45 percent, respectively.

Overall, the therapeutic effect was better with EPNS than with TES (p<0.01).

The pudendal nerve stems from sacral S2-4 nerve roots and divides into three terminal branches: the inferior rectal, perineal and dorsal nerves. It provides sensory innervation to the anal, perineal and genital regions, as well as supplies motor control to the external anal and external urethral sphincters and the pelvic floor muscles. [Pain Physician 2014;17:E645-E650]