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Volume 183, Issue 4, Pages 1438-1443 (April 2010)


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Randomized Trial of Percutaneous Tibial Nerve Stimulation Versus Sham Efficacy in the Treatment of Overactive Bladder Syndrome: Results From the SUmiT Trial

Kenneth M. PetersaCorresponding Author Informationemail address, Donna J. Carricoa, Ramon A. Perez-Marreroc, Ansar U. Khand, Leslie S. Wooldridgeb§, Gregory L. Davise, Scott A. MacDiarmidf

Received 20 August 2009 published online 22 February 2010.

Refers to article:
Under Treatment of Overactive Bladder , 19 February 2010
Katie N. Ballert
The Journal of Urology
April 2010 (Vol. 183, Issue 4, Pages 1282-1283)
Full Text | Full-Text PDF (91 KB)
Purpose

The Study of Urgent® PC vs Sham Effectiveness in Treatment of Overactive Bladder Symptoms (SUmiT) was a multicenter, double-blind, randomized, controlled trial comparing the efficacy of percutaneous tibial nerve stimulation to sham through 12 weeks of therapy. The improvement in global response assessment, voiding diary parameters, and overactive bladder and quality of life questionnaires was evaluated.

Materials and Methods

A total of 220 adults with overactive bladder symptoms were randomized 1:1 to 12 weeks of treatment with weekly percutaneous tibial nerve stimulation or sham therapy. Overactive bladder and quality of life questionnaires as well as 3-day voiding diaries were completed at baseline and at 13 weeks. Subject global response assessments were completed at week 13.

Results

The 13-week subject global response assessment for overall bladder symptoms demonstrated that percutaneous tibial nerve stimulation subjects achieved statistically significant improvement in bladder symptoms with 54.5% reporting moderately or markedly improved responses compared to 20.9% of sham subjects from baseline (p <0.001). All individual global response assessment subset symptom components demonstrated statistically significant improvement from baseline to 13 weeks for percutaneous tibial nerve stimulation compared to sham. Voiding diary parameters after 12 weeks of therapy showed percutaneous tibial nerve stimulation subjects had statistically significant improvements in frequency, nighttime voids, voids with moderate to severe urgency and urinary urge incontinence episodes compared to sham. No serious device related adverse events or malfunctions were reported.

Conclusions

This pivotal multicenter, double-blind, randomized, sham controlled trial provides level I evidence that percutaneous tibial nerve stimulation therapy is safe and effective in treating overactive bladder symptoms. The compelling efficacy of percutaneous tibial nerve stimulation demonstrated in this trial is consistent with other recently published reports and supports the use of peripheral neuromodulation therapy for overactive bladder.

a Beaumont Hospital, Royal Oak, Michigan

b Mercy Health Partners, Muskegon, Michigan

c Advanced Research Institute, Trinity, Florida

d Urology Health Center, Fremont, Nebraska

e Chico, California

f Alliance Urology Specialists, Greensboro, North Carolina

Corresponding Author InformationCorrespondence: Department of Urology, Beaumont Royal Oak, 3535 W. 13 Mile Rd., Suite 438, Royal Oak, Michigan 48073 (telephone: 248-551-0387; FAX: 248-551-8107)

 Study received institutional review board approval.

 Supported by Uroplasty, Inc.

 See Editorial on page 1282.

 Financial interest and/or other relationship with Medtronic and Uroplasty.

 Financial interest and/or other relationship with Solvay, GSK and Novartis.

§ Financial interest and/or other relationship with Uroplasty, Astellas and Watson.

 Financial interest and/or other relationship with Ortho Women's Health and Urology Speaker Bureau.

 Financial interest and/or other relationship with Astellas, Allergan, Pfizer, Watson and Uroplasty.

PII: S0022-5347(09)03200-5

doi:10.1016/j.juro.2009.12.036


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