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Master Thesis

Efficacité comparée de la stimulation transcutanée unilatérale et bilatérale du nerf tibial pour le traitement de l'hyperactivité vésicale neurologique : résultats préliminaires d'une étude prospective randomisée

Abstract : Introduction: Urinary disorders are frequently found in neurological diseases. Tibial nerve stimulation (TNS) is a safe and effective therapy in the treatment of neurological overactive bladder (OAB). However, in current practice, the stimulation modalities are still very heterogeneous. The aim of this study was to compare the efficacy of unilateral and bilateral TNS in the treatment of neurological OAB. Materials and methods: 18 patients with neurological OAB at low detrusorian pressure were included in this study. They were randomized into two groups, one group being treated with unilateral TNS and the other group being treated with bilateral TNS. The primary criteria were the change in Urinary Symptom Profile (USP) score after 3 months of treatment. The secondary criteria were the analysis of the mictional calendar data, the change in the Patient global Impression of Severity (PGI-S) scale and the Patient Global Impression of Improvement (PGI-I) scale after 3 months of treatment. Results: After 3 months of treatment, a decrease of more than 50% in the USP score was found in 9 patients included in the study. There was a trend towards a better efficacy of bilateral TNS on the USP score as well as a decrease in urine leaks, the decrease of pollakiuria and on the PGI-I score analysis. Unilateral TNS appeared to be more effective in improving the USP score. These results are not statistically significant. Discussion: These results are preliminary results from a study with a larger patient population. If the results of the finalized study are in favour of better efficacy of bilateral TNS, it would be interesting to homogenize stimulation practices by stimulating all patients bilaterally. Moreover, this stimulation modality could have a double interest in patients with ano-rectal disorders. Conclusion: Bilateral TNS seems to be of interest for the treatment of neurological OAB. Since the results are not significant, the study should be finalized to include a larger number of patients.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03197704
Contributor : Ufr Santé Unicaen <>
Submitted on : Wednesday, April 14, 2021 - 10:04:55 AM
Last modification on : Wednesday, June 16, 2021 - 3:35:14 AM
Long-term archiving on: : Thursday, July 15, 2021 - 6:12:14 PM

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  • HAL Id : dumas-03197704, version 1

Citation

Hélène Lardreau. Efficacité comparée de la stimulation transcutanée unilatérale et bilatérale du nerf tibial pour le traitement de l'hyperactivité vésicale neurologique : résultats préliminaires d'une étude prospective randomisée. Médecine humaine et pathologie. 2020. ⟨dumas-03197704⟩

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