ABSTRACT
Objective
To evaluate percutaneous tibial nerve stimulation (PTNS) maintenance therapy dropout
rates and identify factors associated with compliance in an American population.
Methods
We retrospectively queried our PTNS database for patients from 2014-2019. Demographic,
relevant clinical, and visit data were collected. Maintenance therapy was patient-driven
and frequency of sessions was tapered based on symptomology. Upon completion of 12
initial sessions, we assessed dropout from maintenance at 3, 6, 9, and 12 months.
Multiple variables were tested for correlation with dropout in patients continuing
maintenance therapy for 1 year vs those who dropped out.
Results
One hundred and sixty-three PTNS patients were identified, of which 104 completed
initial therapy and 81 proceeded with maintenance therapy. At 3, 6, 9, and 12 months,
maintenance continuation rates were 77.8% (63/81), 58.0% (47/81), 45.6% (37/81), and
39.5% (32/41), respectively. Primary reasons for dropout were worsening of urinary
symptoms/lack of efficacy (n = 21), time commitment (n = 9), loss of insurance (n = 5), medical comorbidities (n = 4), request for alternative OAB treatment (n = 2), and unknown (n = 8). On both univariate and multivariate analysis, perceived symptom improvement
(P<.01; HR = 0.02, P< .01) was associated with continuing maintenance therapy. On only univariate analysis,
neurological history (P = .02) and multiple sclerosis history (0.02) were associated with continuing therapy.
Conclusion
Only 39.5% of patients continue to undergo maintenance PTNS therapy after 1 year.
Future studies are required to understand and ameliorate factors for low compliance
in PTNS maintenance therapy.
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Article info
Publication history
Published online: February 10, 2021
Accepted:
February 2,
2021
Received:
September 16,
2020
Footnotes
Acknowledgements: This study has no source of funding. The authors have no relevant financial disclosures to make.
Identification
Copyright
Published by Elsevier Inc.