INTRODUCTION: Overactive bladder (OAB) is a common condition that significantly impacts quality of life, particularly among older women. Estrogen therapy and percutaneous tibial nerve stimulation (PTNS) are both effective treatments for OAB, but the relationship between estrogen use and PTNS treatment outcomes has not been well studied. OBJECTIVE: This study aimed to evaluate whether estrogen supplementation is associated with improved PTNS response in women with OAB. METHODS: We conducted a retrospective chart review of women who underwent PTNS between January 1, 2017, and December 31, 2022, at a single academic medical center. Patients were classified into an estrogen group and a non-estrogen group based on estrogen supplementation use during treatment. Treatment success at six and twelve weeks was defined as any documented improvement in OAB symptoms. Fisher’s two-tailed exact test was used to assess associations between estrogen use and treatment success. RESULTS: Thirty-nine women met inclusion criteria (20 in the estrogen group; 19 in the non-estrogen group). At six weeks, 13 of 20 patients in the estrogen group (65%) and 5 of 19 patients in the non-estrogen group (26.3%) reported symptom improvement (p=0.025; OR 5.20). At twelve weeks, success rates increased to 70% (14 of 20) in the estrogen group and 42.1% (8 of 19) in the non-estrogen group, but this difference was not statistically significant (p=0.111; OR 3.21). CONCLUSIONS: Estrogen therapy was associated with significantly greater PTNS treatment success at six weeks, with a trend toward higher success at twelve weeks. These findings suggest that estrogen supplementation may enhance early PTNS efficacy in women with OAB. Prospective studies are needed to confirm these results and clarify the long-term impact of estrogen on neuromodulation outcomes.Table 1
Ross et al. (Fri,) studied this question.