Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis

Introduction and hypothesis This systematic review and meta-analysis aimed to evaluate the efficacy and safety of percutaneous tibial nerve stimulation (PTNS) for the treatment of overactive bladder (OAB) syndrome. Methods PubMed, Embase, Web of Science and Cochrane Library were searched systematically to identify all the relevant studies. Void frequency per day, nocturia frequency per day, urgency episodes per day, incontinence episodes per day, urodynamic values, success rate and side effects, etc., were extracted from the included studies and analyzed. Results Twenty-eight studies with 2461 patients in total were included. Results showed that there was a significant clinical effect on the voiding frequency per day (MD = -2.48; 95% CI -3.19, -1.76;P< 0.001), nocturia frequency per day (MD = -1.57; 95% CI -2.16, -0.99;P< 0.001), urgency episodes per day (MD = -2.20; 95% CI -3.77, -0.62;P = 0.006), incontinence episodes per day (MD = -1.37; 95% CI -1.71, -1.02;P< 0.001), maximum cystometric capacity (MD = 63.76; 95% CI 31.90, 95.61;P< 0.001) and compliance (MD = 7.62; 95% CI 0.61, 14.63;P = 0.033). The pooled success rate was 0.68 (95% CI 0.59, 0.78). The major complication was the pain at the puncture site, but the incidence was low. Conclusions PTNS is effective and safe in treating OAB symptoms.