Short-term additive effect of posterior tibial nerve stimulation in neurogenic detrusor overactivity among incomplete spinal cord injury patients on antimuscarinic therapy: A prospective study

Objective To determine the short-term additive effect of transcutaneous posterior tibial nerve stimulation (PTNS) in patients with incomplete spinal cord injury (SCI) with neurogenic detrusor overactivity (NDO) receiving antimuscarinic therapy.Design All 29 patients with urinary incontinence underwent a baseline cystometry followed by a 15-session therapy of PTNS. Stimulation was delivered with a pulse width of 200 microseconds, a frequency of 20 Hz, and a current intensity of 10-40 mA for 15 min. After completion of the intervention, patients were reassessed with a repeat cystometry.Setting The study was conducted in the department of Physical Medicine and Rehabilitation of a tertiary care center.Participants SCI patients with NDO.Interventions Transcutaneous stimulation of the posterior tibial nerve to alleviate detrusor overactivity.Outcome measures UDS parameters comparing pre- and post- intervention.Results The mean age of the study group was 44.5 ± 12.9 years. Significant improvements were observed following intervention, with an increase in the reflex volume (ΔRV = −111 mL, p < 0.001) and maximum cystometric capacity (ΔMCC = −134 mL, p < 0.001), alongside a reduction in maximum detrusor pressure (ΔMDP = 14.9cmH2O, p < 0.001). Level of injury demonstrated a significant association with changes in reflex volume (p = 0.001), but the changes in maximum cystometric capacity (p = 0.105) or maximum detrusor pressure (p = 0.138) did not suggest any statistical significance.Conclusion Transcutaneous PTNS improved urodynamic parameters in incomplete spinal cord injury with neurogenic detrusor overactivity undergoing prolonged antimuscarinic therapy.