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July2013 Vol.50 Issue:        3       (Supp.) Table of Contents
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Efficacy of Posterior Tibial Nerve Stimulation on Detrusor Overactivity of Idiopathic Parkinson’s Disease Patients Clinical and Urodynamic Evaluation

Mohamed Y. El-Senousy1, Ehab S. Mohammed1, Hazem A. Fayed1, Ehab A. El-Seidy1, Mohamed K.Khalil1, Mohamed Abo  El-Enen2, Maged M. Ragab2, Mohamed Elnady2, Mohamed R. Taha2

Departments of Neurology1, Urology2, Tanta University; Egypt

 



ABSTRACT

Background: Lower urinary tract dysfunction is often occurs in patients with Parkinson's disease (PD) that is primarily induced by neurogenic detrusor overactivity (NDO). Objective: To evaluate the clinical and urodynamic effects of posterior tibial nerve stimulation (PTNS) on NDO of PD patients. Methods: Thirty-three patients with PD and were subjected to weekly treatment with percutaneous PTNS for 12 weeks. The clinical manifestations such as nocturia, frequency of micturition and incontinence episodes were analyzed before and after PTNS using voiding diary, international prostate symptom (IPSS) and quality of life (QOL) scores.  Filling and voiding cystometry were done for comparison of the urodynamic parameters suggestive of NDO namely volume at first involuntary detrusor contraction (1st IDCV), maximum detrusor pressure (Pdetmax) and maximum cystometric capacity (MCC). Result:  Frequency and leakage episodes have significantly decreased from a mean of 10.5±2.1 and 3.5±1.0 to a mean of 7.8±1.2 and 2.2±0.7 respectively (P<0.01). Meanwhile nocturia decreased from 3.4±0.8 to 2.1±0.8 (P=0.06). IPSS and QOL were significantly better after PTNS. Likewise, urodynamic parameters also significantly improved. Mean 1st IDCV and MCC significantly increased after PTNS from a mean of 150.6±46.6 and 232.9±63.1 to 271.3±67.3 and 329.1±65.7 respectively (P<0.01). No serious adverse events or side effects were observed during or after treatment. Conclusion: The use of PTNS in IPD patients with overactive bladder are encouraging for amelioration of detrusor overactivity and improving bladder storage symptoms. However, long-term follow-up is needed for planning to maintenance protocols. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(3): 265-270]

Key Words: Parkinson's disease, detrusor overactivity, posterior tibial nerve stimulation.

Correspondence to Ehab S. Mohammed, Department of Neurology, Tanta University Egypt.

Tel: +201144656670    E-mail:ehab_metwally70@yahoo.com





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