The Role of Neuromodulation (PTNS/ SNS) in Refractory Overactive Bladder: Long-Term Outcomes

Authors

  • Noor Hussain Almousa Consultant Urogynecology & Reconstructive Pelvic Surgery, Riyadh First Cluster King Saud Medical City, Women Health Hospital, Saudi Arabia Author
  • Saad Khaleel Alonze Obstetrics and Gynecology Registrar, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia Author
  • Duaa Shafiq Alwahidi Obstetrics and Gynecology Resident, Alyamamh Hospital, Saudi Arabia Author
  • Somaya Ibrahim Alghamdi Obstetrics and Gynecology Resident, King Abdulaziz Hospital Almahjer, Saudi Arabia Author
  • Maram Jarallah Obstetrics and Gynecology Resident, Riyadh Second Health Cluster, Saudi Arabia Author
  • Ghada Saleh H Albalawi Obstetrics and Gynecology Resident, Tabuk Maternity & Children Hospital, Saudi Arabia Author
  • Reema Faleh Mohammed Alanazi Obstetrics and Gynecology Resident, Imam Abdulrahman Al Faisal Hospital- NGHA - Dhahran, Saudi Arabia Author
  • Hind Mousa Ahmad Faqeeh Obstetrics and Gynecology Resident, AlKhamis Maternity and Children Hospital, Saudi Arabia Author
  • Adnan Alhazmi Obstetrics and Gynecology Resident, King Fahad Medical City (KFMC) – Riyadh Second Health Cluster, Saudi Arabia Author
  • Malak Dhaifallah Alanazi Obstetrics and Gynecology Resident, MCH Tabuk, Saudi Arabia Author
  • Gofran Mohammed Al Braheem Obstetrics and Gynecology Resident, Maternity and Children Hospital, Al Hasa Health Cluster, Ministry of Health, Saudi Arabia Author
  • Salem Abdulaziz Salem Islam Associate Consultant Obstetrics and Gynecology, Riyadh First Cluster King Saud Medical City, Women Health Hospital, Saudi Arabia Author
  • Shaikha Sulayyem Salamah Alsharari PGY5, King Saud Medical City Author

DOI:

https://doi.org/10.65759/jvkd1w12

Keywords:

Overactive bladder, Refractory OAB, Neuromodulation, Sacral Nerve Stimulation, Percutaneous Tibial Nerve Stimulation

Abstract

Background: Overactive bladder (OAB) imposes a significant global health and economic burden. While behavioral and pharmacological treatments are standard, many patients become refractory. Neuromodulation, specifically Sacral Nerve Stimulation (SNS) and Percutaneous Tibial Nerve Stimulation (PTNS), offers a third-line alternative, but data on their long-term durability is still varied. Methods: Following PRISMA guidelines, a systematic review was conducted in PubMed, Scopus, and Web of Science for studies from 2007 to 2026 reporting clinical outcomes for refractory OAB with a minimum 24-month follow-up. Methodological quality was assessed using the Newcastle Ottawa Scale. Results: Nine studies met the inclusion criteria. SNS show high long-term success rates, ranging from 47% at nearly 10 years to 82% at 5 years. SNS was associated with surgical revision rates up to 33% due to lead migration or loss of efficacy. PTNS show a strong durability in responders, with 77% maintaining improvement at three years. Long-term PTNS adherence is a challenge, with one study reporting 25% patient retention at three years. Both modalities improved Qol. Conclusion: SNS and PTNS provide effective long-term management for refractory OAB. SNS offers high durability but requires surgical revisions, while PTNS provides a better safety profile and it heavily dependent on patient adherence to maintenance schedules.

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Published

2026-04-14

Issue

Vol. 3 No. 2 (2026): Journal of Tazeez for Public Health

Section

Articles