A Comprehensive Evaluation Of Children Experiencing Percutaneous Tibial Nerve Stimulation (Ptns) For Overactive Bladder (Oab) Refractory To Behaviour And Pharmacological Treatments
PURPOSE To report the impact and tolerability of PTNS and the effect on the child's reported quality of life. MATERIAL AND METHODS Prospective data from 8 children (M:F 1:7; mean age 12 years 3 months) with OAB demonstrated on urodynamics. PTNS was performed weekly for 30 minutes over 12 weeks. Symptoms (voiding diary, dry pie chart) objective measures (uriflow, post void residual (PVR), needle pain score, urge score, PinQ score) and child's thoughts about the experience were recorded. RESULTS The number of days per week of incontinence ranged from 2-7 (mean 4 days) two had nocturnal enuresis (NE), one sporadic NE, none had faecal incontinence. Seven had urge/frequency and 2 had a history of symptomatic UTI within last 6 months. Four of the eight children with incontinence became dry, 1 significantly improved. Three children had no improvement 2/3 had recurrent UTI. Noninvasive uriflow and PVR were not statistically significant before and after treatment. Pre-treatment patient age, sex and frequency of wetting were not predictive of outcome. PinQ score changed demonstrating an improvement in QoL. Pain scores were low or absent in all children. Qualitative themes included improved confidence and positive fun experiences. There were no reported side effects or adverse events. CONCLUSIONS PTNS for children that have failed previous standard treatments is safe and well tolerated. It is not reported as painful and improvement in continence was reflected in QoL score for most children. Weekly treatments impact on family life and some families had difficulties meeting this commitment. Long term outcome data collection is in progress.