Scott A MacDiarmid1, M Sasha John2, Paul B Yoo2,3. 1. Alliance Urology Specialists, Greensboro, North Carolina. 2. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada. 3. Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada.
Abstract
AIMS: Effective long-term treatment of overactive bladder (OAB) remains a significant clinical challenge. We present our initial experience with a new bladder neuromodulation method that electrically targets the saphenous nerve (SAFN). METHODS: A total of 18 OAB patients (female, 55-84 years) were provided with percutaneous SAFN stimulation. The SAFN was targeted with a needle electrode inserted below the medial condyle of the tibia. Activation of the SAFN was confirmed by the patient's perception of paresthesia radiating down the leg. Electrical stimulation was applied for 30 min and subsequently repeated weekly for 3 months. The effects of stimulation were assessed by a 4-day bladder diary and quality-of-life questionaire (OAB-q). RESULTS: Percutaneous SAFN stimulation was confirmed in all 16 patients who completed the study, and no adverse events were reported. Positive response to SAFN stimulation was achieved in 87.5% (14 of 16) of patients, as determined by either a minimum 50% reduction in bladder symptoms or a minimum 10 point increase in the HRQL total score. CONCLUSIONS: Electrical activation of the SAFN was consistently achieved using anatomical landmarks and patient feedback. The procedure was well tolerated and, based on our small cohort of patients, appears efficacious, and safe. This pilot study provides early feasibility data that points to a promising new intervention for treating OAB.
AIMS: Effective long-term treatment of overactive bladder (OAB) remains a significant clinical challenge. We present our initial experience with a new bladder neuromodulation method that electrically targets the saphenous nerve (SAFN). METHODS: A total of 18 OABpatients (female, 55-84 years) were provided with percutaneous SAFN stimulation. The SAFN was targeted with a needle electrode inserted below the medial condyle of the tibia. Activation of the SAFN was confirmed by the patient's perception of paresthesia radiating down the leg. Electrical stimulation was applied for 30 min and subsequently repeated weekly for 3 months. The effects of stimulation were assessed by a 4-day bladder diary and quality-of-life questionaire (OAB-q). RESULTS: Percutaneous SAFN stimulation was confirmed in all 16 patients who completed the study, and no adverse events were reported. Positive response to SAFN stimulation was achieved in 87.5% (14 of 16) of patients, as determined by either a minimum 50% reduction in bladder symptoms or a minimum 10 point increase in the HRQL total score. CONCLUSIONS: Electrical activation of the SAFN was consistently achieved using anatomical landmarks and patient feedback. The procedure was well tolerated and, based on our small cohort of patients, appears efficacious, and safe. This pilot study provides early feasibility data that points to a promising new intervention for treating OAB.
Authors: Robert F Hoey; Daniel Medina-Aguiñaga; Fahmi Khalifa; Beatrice Ugiliweneza; Sharon Zdunowski; Jason Fell; Ahmed Naglah; Ayman S El-Baz; April N Herrity; Susan J Harkema; Charles H Hubscher Journal: Sci Rep Date: 2021-02-08 Impact factor: 4.379
Authors: Robert F Hoey; Daniel Medina-Aguiñaga; Fahmi Khalifa; Beatrice Ugiliweneza; Dengzhi Wang; Sharon Zdunowski; Jason Fell; Ahmed Naglah; Ayman S El-Baz; April N Herrity; Susan J Harkema; Charles H Hubscher Journal: Sci Rep Date: 2022-02-08 Impact factor: 4.996