Clinical utility of neurostimulation devices in the treatment of overactive bladder: current perspectives

This review describes the evidence from established and experimental therapies that use electrical nerve stimulation to treat lower urinary tract dysfunction. Clinical studies on established treatments such as percutaneous posterior tibial nerve stimulation (P-PTNS), transcutaneous electrical nerve...

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Bibliographic Details
Published in:Medical devices (Auckland, N.Z.) N.Z.), 2017-01, Vol.10, p.109-122
Main Authors: Janssen, Dick Aw, Martens, Frank Mj, de Wall, Liesbeth L, van Breda, Hendrikje Mk, Heesakkers, John Pfa
Format: Article
Language:English
Subjects:
Bladder
Brain stimulation
Care and treatment
Electrodes
Health aspects
implant
Multiple sclerosis
Nervous system
neuromodulation
Patients
PTNS
Quality of life
Review
Risk factors
sacral anterior root stimulation
sacral nerve stimulation
Spinal cord
Systematic review
Transcutaneous electrical nerve stimulation-TENS
Urinary incontinence
Urine
Urogenital system
Urology
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Summary:This review describes the evidence from established and experimental therapies that use electrical nerve stimulation to treat lower urinary tract dysfunction. Clinical studies on established treatments such as percutaneous posterior tibial nerve stimulation (P-PTNS), transcutaneous electrical nerve stimulation (TENS), sacral nerve stimulation (SNS) and sacral anterior root stimulation (SARS) are evaluated. In addition, clinical evidence from experimental therapies such as dorsal genital nerve (DGN) stimulation, pudendal nerve stimulation, magnetic nerve stimulation and ankle implants for tibial nerve stimulation are evaluated. SNS and P-PTNS have been investigated with high-quality studies that have shown proven efficacy for the treatment for overactive bladder (OAB). SARS has proven evidence-based efficacy in spinal cord patients and increases the quality of life. TENS seems inferior to other OAB treatments such as SNS and P-PTNS but is noninvasive and applicable for ambulant therapy. Results from studies on experimental therapies such as pudendal nerve stimulation seem promising but need larger study cohorts to prove efficacy. Neurostimulation therapies have proven efficacy for bladder dysfunction in patients who are refractory to other therapies. Refinement of neurostimulation therapies is possible. The aim should be to make the treatments less invasive, more durable and more effective for the treatment of lower urinary tract dysfunction.
ISSN:1179-1470
1179-1470
DOI:10.2147/MDER.S115678