[Eposterior tibial nerve stimulation in overactive bladder and bowel incontinence]

Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A.
Record ID 32018001560
Original Title: Estimulación del nervio tibial posterior en vejiga hiperactiva e incontinencia fecal
Authors' recommendations: Moderate quality evidence suggests that transcutaneous and percutaneous posterior tibial nerve stimulation is superior to sham stimulation when treating patients with overactive bladder (at short term) and bowel incontinence (at short and medium term), which are refractive to standard treatment. In addition, moderate quality suggests that the technology would be superior to one of the pharmacological alternatives used in overactive bladder syndrome, the tolterodine. However, no evidence comparing it with other drugs has been found. Moderate quality evidence suggests that posterior tibial nerve stimulation would be less effective than sacral stimulation when treating bowel incontinence. Posterior tibial nerve stimulation is recommended for overactive bladder by most of the clinical practice guidelines surveyed, after dietary and hygiene measures, pelvic floor exercises and pharmacological treatment, which remain as the standard of care for these patients. The guidelines hardly recommend the use or do not mention posterior tibial nerve stimulation in bowel incontinence treatment. State-owned health providers from the United Kingdom and the United States and private funders from the latter cover posterior tibial nerve stimulation in overactive bladder; although some of them only cover percutaneous nerve stimulation. Most of them consider it as experimental and do not cover it in patients with bowel incontinence. No domestic economic studies on the cost-effectiveness of this technology for the indications assessed have been found.
Project Status: Completed
Year Published: 2019
URL for published report: https://www.iecs.org.ar/home-ets/
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Urinary Incontinence
  • Urinary Bladder, Overactive
  • Fecal Incontinence
  • Electric Stimulation Therapy
  • Tibial Nerve
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.