| Objectives: Percutaneous and transcutaneous posterior tibial nerve stimulation (PTNS and TTNS) showed a promising effect on overactive bladder (OAB)
and interstitial cystitis/painful bladder syndrome. We aimed to give a systematic review and meta‐analysis on the efficacy and safety of these therapeutic methods as well.
Methods: We searched studies available on PubMed, Embase, Cochrane,
Scopus, Web of Science, and ProQuest on March 31, 2021, to find both published and unpublished studies. The retrieved articles were screened by two
independent researchers and then the selected studies were critically appraised by Cochrane risk‐of‐bias tool for randomized trials, and Joanna Briggs
Institute's checklist for quasi‐experimental studies. Finally, the results of
studies were synthesized using Review Manager (RevMan) 5.4 statistical
software when the data were homogenous. The meta‐analysis was performed
by calculating the effect size (mean difference) and their 95% confidence intervals (CIs).
Neurourology and Urodynamics. 2022;41:539–551. wileyonlinelibrary.com/journal/nau © 2022 Wiley Periodicals LLC | 539
Results: Of the total 3194 publications, 68 studies were included in our
qualitative evaluation and 9 studies (11 trials) in the quantitative stage. When
TTNS or PTNS were compared to sham, placebo, no treatment, or conservative
management, a decrease in frequency of urination was observed in both TTNS
(mean difference [MD]: −3.18, 95% CI: −4.42 to −1.94, and p < 0.00001), and
PTNS (MD: −2.84, 95% CI: −4.22 to −1.45, and p < 0.00001), and overall TTNS
or PTNS (MD: −2.95, 95% CI: −4.01 to −1.88, and p < 0.00001). Significant
improvements in mean voiding volume (MVV) and decreasing nocturia were
also observed.
Conclusions: Nerve stimulations either PTNS or TTNS appear to be effective
interventions in treating refractory idiopathic OAB in terms of daily voiding
frequency, MVV, urgency episodes, and nighttime voiding frequency. However, our result did not show any improvement in terms of urinary incontinence, postvoid residual volume or urge incontinence, and maximum
cystometric capacity which emphasized the efficacy of these modalities on dry‐
OAB rather than wet‐OAB. |