Overactive bladder (OAB) syndrome is characterized by urinary urgency, frequency, and nocturia, with or without incontinence, in the absence of infection or other underlying conditions Third-line treatments, including botulinum toxin injections, sacral neuromodulation, and tibial nerve stimulation, are used for refractory cases. Percutaneous tibial nerve stimulation (PTNS) is a minimally invasive therapy that may improve symptoms and quality of life (QoL) [1,2].
This study aimed to evaluate the effectiveness of PTNS in reducing OAB symptoms and its impact on QoL using the ICIQ-OAB and ICIQ-OAB QoL questionnaires.

A retrospective study was conducted on patients treated with PTNS between January and July 2023. The study included individuals over 18 years old who exhibited persistent OAB symptoms despite behavioral and pharmacological interventions. The treatment protocol consisted of 12 weekly PTNS sessions using the Medware Ecud Confident device, with each session lasting 30 minutes. The ICIQ-OAB and ICIQ-OAB QoL questionnaires were administered at baseline, at the end of the treatment course, and one month post-treatment to assess symptom severity and impact on daily life. (Figure 1)

A total of 56 patients were included. At baseline, all patients (100%) reported urinating at least 13 times per day. Following PTNS, 30 patients (53.57%) reduced their frequency to 7 episodes per day, while 26 patients (46.42%) lowered their frequency to 9 episodes. Nocturia, present in 89.3% of patients at baseline (≥4 episodes per night), decreased by 50% (to 2 episodes per night) after treatment.
For the ICIQ-OAB questionnaire (scored 0-16, higher scores indicating more severe symptoms), the mean baseline score was 13, improving to 4 after treatment, with a slight increase to 5 one month later. The ICIQ-OAB QoL questionnaire (scored 25-160, higher scores indicating greater impact on QoL) showed an initial mean score of 99, improving to 47 after treatment, with a slight increase to 49 at follow-up. (Table 1)

PTNS significantly reduced OAB symptoms, including daytime frequency and nocturia, and improved QoL. A slight increase in symptoms one month post-treatment suggests the potential need for maintenance therapy. These findings support PTNS as an effective and well-tolerated treatment option for OAB.

PTNS is an effective treatment for OAB, providing significant symptom relief and improving quality of life in patients with persistent urinary urgency, frequency, and nocturia. The therapy demonstrates a favorable safety profile, reinforcing its role in the management of refractory OAB. Further research is warranted to explore the long-term durability of symptom improvement and the optimal maintenance treatment schedule.

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