Re: Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study

I thank the authors of “Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study (1).” I support the importance you attribute to intravaginal electrical stimulation (IVES) and percutaneous tibial nerve stimulation (PTNS) in the management of idiopathic overactive bladder (OAB). The authors stated that PTNS is more effective than IVES in women with idiopathic OAB. Women with antimuscarinic naive OAB were included in this study (1). However, it is known that many patients with idiopathic OAB receive pharmacological treatment before reaching a conservative treatment option such as IVES. As the authors stated, in common practice, antimuscarinic agents are frequently used as an initial treatment although burdened by a low adherence, and these patients need protracted treatment with periodic controls.