Mp21-09 Posterior Tibial Nerve Stimulation for Refractory Overactive Bladder in Pediatrics: Symptom Score & Quality of Life Improvement

You have accessJournal of UrologyPediatrics II (MP21)1 May 2024MP21-09 POSTERIOR TIBIAL NERVE STIMULATION FOR REFRACTORY OVERACTIVE BLADDER IN PEDIATRICS: SYMPTOM SCORE & QUALITY OF LIFE IMPROVEMENT Adriana Messina, Katherine M. Fischer, Keely McClatchy, Danielle Kaiser, Christine Hochwind, Lauren Heaston, Sameer Mittal, and Jason Van Batavia Adriana MessinaAdriana Messina , Katherine M. FischerKatherine M. Fischer , Keely McClatchyKeely McClatchy , Danielle KaiserDanielle Kaiser , Christine HochwindChristine Hochwind , Lauren HeastonLauren Heaston , Sameer MittalSameer Mittal , and Jason Van BataviaJason Van Batavia View All Author Informationhttps://doi.org/10.1097/01.JU.0001008844.84871.17.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite appropriate treatment of lower urinary tract symptoms (LUTS) with urotherapy, biofeedback, and medications, many children will have persistent symptoms. For adults with refractory symptoms, guidelines recommend neuromodulation, however, use in pediatrics is less defined. Our objective was to review our experience with posterior tibial nerve stimulation (PTNS) in pediatric patients for refractory non-neurogenic overactive bladder (OAB). We hypothesized that patients would have a significant improvement in LUT symptom and QOL scores after completing PTNS. METHODS: Since April 2022 we have prospectively followed all patients treated with PTNS for refractory non-neurogenic OAB. Criteria were: failed urotherapy and at least one antimuscarinic or beta-3 agonist. Failure was defined as 11 points. Constipation was treated prior to PTNS. Induction of PTNS was 12 weekly 30-minute sessions in the office with 34 gauge needle. After induction, patients may continue to receive PTNS every other week for 6 months then monthly for up to 2 years. All patients fill out weekly questionnaires (DVISS, pediatric incontinence quality of life PinQ). All patients who underwent at least 12 sessions were included. Differences between initial and scores at endpoints throughout treatment were compared using Wilcoxin signed rank test. RESULTS: 13 patients started PTNS at median age 13.6 years (IQR 11.3-17.7). Median starting DVISS score was 19 (IQR 13-25) and decreased to 10 (IQR 8-14) after 12 weekly sessions (p<0.01). At last follow up (median 18 sessions) DVISS score decreased to 9 (IQR 8-11, p<0.01). 9 of 13 patients had a decrease in DVISS score by the 6th session, 11 of 13 by 12th session and 12 of 13 (92.3%) had a decrease at last follow up. Median PinQ scores also decreased significantly from initial score of 40 (IQR 17-43) to 8 (IQR 5-21.5) at final follow up (p<0.01). CONCLUSIONS: The majority of children with refractory OAB will have objective improvements in symptom score and QoL after induction of PTNS and these benefits persist during maintenance PTNS. Patients should be made aware that improvement may take longer than 6 weeks and that some patients continue to improve after the first 12 weeks of PTNS. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e332 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Adriana Messina More articles by this author Katherine M. Fischer More articles by this author Keely McClatchy More articles by this author Danielle Kaiser More articles by this author Christine Hochwind More articles by this author Lauren Heaston More articles by this author Sameer Mittal More articles by this author Jason Van Batavia More articles by this author Expand All Advertisement PDF downloadLoading ...