PTNS beneficial in Parkinson’s disease with detrusor activity

03 Aug 2021

For Parkinson's disease patients with detrusor activity, percutaneous posterior tibial nerve stimulation (PTNS) treatment with a tapering protocol helps improve voiding and urodynamic parameters, as shown in a study.

A total of 76 patients (57.9 percent male) underwent PTNS for 12 weeks. After which, PTNS was administered at 14-day intervals for 3 months, 21-day intervals for another 3 months, and 28-day intervals through 24 months.

All patients completed a 3-day voiding diary and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder V8 (OAB-V8), Overactive Bladder Short Form Questionnaire (OAB-q SF) at months 3, 6, 9, 12, and 24.

Upon treatment conclusion at month 24, daytime voiding frequency decreased by 4.6 daily, urge incontinence episodes by 4.2 daily, and urgency episodes by 6.2 daily. Furthermore, there were significant improvements in nocturia, which decreased by 2.4 voids (p<0.001), and voided volume, which increased by a mean of 71.4 cc (p<0.05).

Likewise, PTNS conferred substantial benefits for the volume at the first involuntary detrusor contraction (1st IDCV), maximum cystometric capacity (MCC), maximal detrusor pressure at first involuntary detrusor contraction (1st IDC Pdetmax), maximal detrusor pressure at MCC (MCC Pdetmax), detrusor pressure at maximal flow (PdetQmax), and postvoid residual volume (PVR). Improvements in these parameters were noted at 3, 12, and 24 months (p<0.001 for each), except maximal flow rate (Qmax) value.

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