Recommendation ID
CG171/2
Question
Neurostimulation:- What is the comparative effectiveness and cost-effectiveness of transcutaneous stimulation of the sacral nerve roots, and transcutaneous and percutaneous posterior tibial nerve stimulation for the treatment of OAB?
Any explanatory notes
(if applicable)
Why this is important:- Transcutaneous neurostimulation can be applied either over the sacrum or over the posterior tibial nerve to modulate the sacral nerve supply to the bladder. The treatment uses surface electrodes and the woman can carry it out in her own home. Percutaneous posterior tibial nerve stimulation involves the introduction of a needle in the region of the posterior tibial nerve near the ankle, and at present is carried out in clinics in secondary care. Currently, it is offered widely as a conservative treatment for OAB without adequate evidence that it is effective. Although this is a relatively low cost treatment, both the equipment and staff time have a cost implication, and because it has been widely used in conservative management this has large resource consequences for the NHS. Robust evidence is needed to establish whether it is a cost-effective option relative to other conservative therapies for all women or for a selected group of patients who are unsuitable for or have unsuccessful botulinum toxin A, percutaneous sacral nerve stimulation or OAB drug treatment.

Source guidance details

Comes from guidance
Urinary incontinence in women: management
Number
CG171
Date issued
September 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 08/10/2013