Estimulación transcutánea del nervio tibial posterior versus darifenacina para el tratamiento de vejiga hiperactiva refractaria en mujeres

Aim

To compare the results of transcutaneous posterior tibial nerve stimulation vs. darifenacin for the treatment of refractory overactive bladder in women.

Material and methods

A quasi-experimental clinical trial was conducted on 30 women diagnosed with refractory overactive bladder. Twenty-two patients received 7.5 mg of oral darifenacin daily and 8 patients had 12 30-min weekly sessions of transcutaneous electrostimulation of the posterior tibial nerve. The patients kept a 3-day urinary diary, underwent pad tests, and the quality of life Bladder Control Self-Assessment Questionnaire and International Consultation on Incontinence Questionnaire were applied at the baseline, at 6 weeks, and at 12 weeks of the study.

Results

At 6 weeks, the patients treated with darifenacin presented with a reduction in urinary frequency (8.27 vs. 11.5, p = 0.236), in nocturia (1.36 vs. 4.25, p = 0.017), and in incontinence episodes (1.32 vs. 3.62, p = 0.041), compared with the patients that received stimulation treatment. In regard to the quality of life questionnaires, at 6 weeks the patients that received darifenacin treatment had a lower score on the self-assessment questionnaire (7.13 vs. 10.14, p = 0.045). In relation to the pad test, after comparing the measurements at the beginning and end of treatment, there was reduced urine leakage in grams with darifenacin (69.32 vs. 2.09, p = 0.041) and with stimulation (42.25 vs. 2.62, p = 0.012), with no statistical significance between the 2 groups (p = 0.753).

Conclusions

Darifenacin was superior to transcutaneous stimulation of the posterior tibial nerve in relation to symptom reduction, urine leakage, and questionnaire scores at 6 weeks. There was no statistically significant difference between the 2 groups at 12 weeks.