New Implantable Tibial Nerve Stimulation Devices: Review of Published Clinical Results in Comparison to Established Neuromodulation Devices

PURPOSE: The purpose of this review is to offer an update for medical providers practicing general urology and urogynecology in evolving and new promising technologies for neuromodulation in patients with OAB. PATIENTS AND METHODS: A focused literature search for the years 2015 through 2019 was conducted on PubMed/Medline for the terms: “new techniques” AND “neuromodulation” AND “tibial nerve stimulation” AND “overactive bladder”. We limited our search to publications in English, for the last five years and with patient follow-up of at least 3 months. RESULTS: Clinical success, safety based on adverse events, and quality of life improvement criteria were evaluated and compared to sacral nerve stimulation (SNS) devices and older, non-implantable percutaneous tibial nerve stimulation (PTNS) treatment devices. Considering the limited number of participants with up to 6 months follow-up data currently available, overall the clinical response rates suggest that the new implantable devices stimulating the tibial nerve have a promising clinical outlook, are less invasive upon implantation than SNS, less expensive, and less of a burden on patients compared to the older non-implantable PTNS devices. CONCLUSION: Practicing urologists should be aware of this new treatment option when counseling their patients regarding treatment for OAB.