Overactive bladder (OAB) is a highly prevalent syndrome among women, with a significant negative impact on quality of life. Multiple studies have demonstrated the efficacy of posterior tibial nerve stimulation (PTNS) in patients with OAB refractory to pharmacological treatment.
Other studies have demostrated the non-inferiority of transcutaneous posterior tibial nerve stimulation (tPTNS) versus percutaneous posterior tibial nerve stimulation (pPTNS) in OAB refractory to other treatment.  
However, no studies have compared the efficacy of unilateral versus bilateral percutaneous PTNS.
The aim of this study was to compare the efficacy of unilateral versus bilateral percutaneous PTNS in women with idiopathic OAB.

Two cohorts of 51 women with idiopathic OAB were retrospectively compared. 
Group 1 (n=25) received unilateral pPTNS, and Group 2 (n=26) received bilateral pPTNS. Both groups underwent one session per week for a total of 12 weeks. 
Patients were evaluated using a 3-day bladder diary (daytime frequency, nocturia, and daily incontinence episodes), validated questionnaires such as OAB-V8 and ICIQ-SF, and treatment satisfaction assessed using a Likert scale.

Both groups were comparable at baseline, with no significant differences observed between them. 
The results are consistent with previously published data. 
No significant differences were found between treatments in terms of daytime frequency, nocturia, or response rates based on validated questionnaires after treatment.

Statistically significant differences were observed in patient satisfaction and the number of daily incontinence episodes. 
Patients treated with bilateral PTNS reported higher satisfaction (3.88 in Group 1 vs 4.35 in Group 2, p<0.021) and a greater reduction in daily incontinence episodes (1.5 in Group 1 vs 0.5 in Group 2, p<0.0001).

Both unilateral and bilateral percutaneous posterior tibial nerve stimulation demonstrated similar clinical efficacy in the treatment of women with idiopathic OAB. 
However, bilateral percutaneous posterior tibial nerve stimulation therapy was associated with higher patient satisfaction and a greater reduction in daily incontinence episodes.
Further  prospective randomized control trials studies are needed to confirm this hypothesis.