Objective: This systematic review summarizes all the published outcomes of urinary problems affecting the quality of life for patients with Parkinson’s disease.

Background: The urinary tract problems associated with Parkinson’s disease increase the risk of falls and affect the quality of life. While current medical treatments have shown conflicting results tibial nerve stimulation can be a solution, as it originates from the same spinal segments that innervate the urinary system organs.

Method: We identified our eligibility criteria and searched 5 databases (WOS, Scopus, Cochrane, PubMed, and PEDro) then we screened the records by title, abstract and full-text screening using El Rayyan. Finally, we extracted the needed data from the included studies for our review.

Results: Three studies with 285 patients were involved. 2 studies used International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) to assess the impact of incontinence symptoms on quality of life. Which showed no statistically significant difference between the 2 groups post-intervention period with a p-value larger than 0.05. 3 studies used the International Prostate Symptom Score (IPSS) and 8-item overactive bladder questionnaire (OAB-V8) to detect overactive bladder symptoms such as urgency, incomplete emptying, and nocturia. 2 studies showed that there was a statistically significant difference for the tibial nerve stimulation group over the control group with p value less than 0.05. One study used king’s health questionnaire to assess the impact of incontinence on quality of life and showed better improvement for the stimulation group than the control regarding general health perception (P =0.025), role limitation (P=0.000), and physical limitation (P=0.000). Moreover, the same study reported maintenance of symptom relief after discontinuing treatment for 90 days follow-up with a difference for the stimulation group with P=0.001.

Conclusion: Tibial nerve stimulation could be an effective and useful tool for the rehabilitation of subjects with Parkinson’s disease suffering from lower urinary tract symptoms such as urgency and nocturia, improving several aspects of quality of life as a physical limitation. In addition to maintaining symptom relief for a long period post-treatment, nonetheless, more randomized controlled studies with larger sample sizes are still needed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-efficacy-of-transcutaneous-tibial-nerve-stimulation-for-parkinsons-urinary-problems-a-systematic-review/