Overactive Bladder Clinical Trial
Official title:
Percutaneous Tibial Nerve Stimulation Maintenance: Monthly Therapy or Per Patient Requested Need
The overall objective of this study is to compare the efficacy of the standard monthly maintenance therapy for percutaneous tibial nerve stimulation (PTNS), to sessions as the patient needs (prn) between 2 weeks and 12 weeks, based on overactive bladder symptoms. This is study is to help determine feasibility for conducting a larger trial that is appropriately powered to provide meaningful data.
Patient will be recruited from the Urogynecology clinic on the first floor of the hospital.
Patients who have completed 12 weeks of PTNS therapy will be identified by the clinic nurse
or nurse practitioner and then a member of the research team will approach the patient
regarding involvement in the study. Patients will be asked if they would like to take part
in this study and will be given the human bill of rights and well as consent forms in their
preferred language (English or Spanish) if they agree to participate. Once they agree to
participate, they will be asked to sign the consent forms in a private patient room.
This is a pilot study for feasibility designed as an equivalence and cost analysis study.
Patients will be recruited at the 12th session of PTNS (conclusion of treatment and before
maintenance therapy starts).
Patients will be from the Urogynecology clinic at Harbor UCLA Medical Center who have OAB
and who have been treated with the standard 12 sessions of PTNS. Patients will be randomized
to "every month PTNS maintenance" or "as needed PTNS maintenance (Q2-12 weeks)." At
enrollment, questions will be read to patients in either Spanish or English based on
patient's preferred language and study staff will fill out the surveys for the patient. The
patient with the study staff will complete the validated questionnaires, Overactive Bladder
Questionnaire (OAB-q), the Benefit, Satisfaction and Willingness to Continue the Treatment
questionnaire (BSW) and the Visual analogue scale for satisfaction with treatment. Urinary
symptoms will be measured by the validated Overactive Bladder Symptom Scale (OAB-SS) and a
modified voiding diary. All patients will have a urine dip completed at this visit to rule
out a bladder infection. Finally patients, with the help of study staff, will answer open
ended questions. All of these measures will be repeated 3 months after enrollment and one
year from enrollment. After the yearlong study, participants can continue treatment which
will be decided by the patient and treating clinician. A cost analysis will compare the cost
to patients and the cost to the clinic between the monthly PTNS maintenance group and the
patient prn maintenance group. All of the above measures will be recorded at enrollment, 3
months from enrollment and 1 year from enrollment. This will be done in person with the help
of the study staff at enrollment and either in person, via the phone or in writing at 3
month and 1 year follow up. No payment and no other recruitment methods will be used.
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