Percutaneous tibial nerve stimulation versus tolterodine for overactive bladder in women: a randomised controlled trial

Eur J Obstet Gynecol Reprod Biol. 2015 Aug;191:51-6. doi: 10.1016/j.ejogrb.2015.05.014. Epub 2015 Jun 3.


Objective: We performed a randomised controlled trial of percutaneous tibial nerve stimulation (PTNS) versus tolterodine for treating treatment naïve women with overactive bladder (OAB).

Study design: 36 patients with symptoms of OAB were randomised to 3 months of treatment with weekly PTNS or tolterodine (2mg bid p.o.). The primary outcome measure was the difference of micturitions per 24h. The secondary outcome measure was the impact on quality of life (QoL) measured with a visual analogue scale (VAS) between baseline and after 3 months of therapy.

Results: Micturition frequencies did not decline significantly (p=0.13) over time and there were no significant treatment differences (p=0.96). QoL was significantly dependent from its level at baseline (p=0.002) and showed improvement over time compared to baseline measurements but no significant differences between both treatment groups (p=0.07). Incontinence episodes per 24h depended significantly on the level at baseline (p=0.0001) and declined significantly (p=0.03) during 3 months of therapy in both therapy groups. However no significant treatment differences on the reduction of incontinence episodes in 24h could be shown between both therapy groups (p=0.89). PTNS had fewer side effects than tolterodine (p=0.04).

Conclusion: PTNS and tolterodine were both effective in reducing incontinence episodes and improving QoL in patients with OAB but not micturition frequencies. PTNS had fewer side effects.

Keywords: Overactive bladder; Percutaneous tibial nerve stimulation (PTNS); Side effects; Tolterodine.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Austria
  • Cholinergic Antagonists / adverse effects
  • Cholinergic Antagonists / therapeutic use*
  • Female
  • Follow-Up Studies
  • Germany
  • Humans
  • Middle Aged
  • Patient Dropouts
  • Pilot Projects
  • Quality of Life*
  • Severity of Illness Index
  • Tibial Nerve / physiopathology*
  • Tolterodine Tartrate / adverse effects
  • Tolterodine Tartrate / therapeutic use*
  • Transcutaneous Electric Nerve Stimulation* / adverse effects
  • Urinary Bladder, Overactive / drug therapy
  • Urinary Bladder, Overactive / physiopathology
  • Urinary Bladder, Overactive / therapy*
  • Urinary Incontinence, Urge / etiology
  • Urinary Incontinence, Urge / prevention & control
  • Urological Agents / adverse effects
  • Urological Agents / therapeutic use*
  • Young Adult


  • Cholinergic Antagonists
  • Urological Agents
  • Tolterodine Tartrate