Compliance with Percutaneous Tibial Nerve Stimulation at a Tertiary Academic Center versus a County Hospital.

Objectives: To compare percutaneous tibial nerve stimulation (PTNS) compliance rate at a safety-net versus tertiary academic hospital and assess the impact of social determinants on compliance.

Methods: Retrospective cohort study of 133 patients at Grady Memorial Hospital and Emory Clinic from May 2015 to March 2020 who had refractory overactive bladder (OAB) and were prescribed PTNS.

Results: Grady patients were younger (age 58.7±11.6 versus 70.7±13.5), predominantly male (52% versus 22%), and predominately African American (80% versus 34%). Compliance rate for PTNS was 55% at Emory and 70% at Grady. In the multivariable model including sex, race, insurance status, income level, and baseline voiding symptoms, Grady patients had 5.31 times the odds of compliance (p=.02).

Conclusions: Compliance rate at a safety-net hospital was greater and was not affected by demographic and socioeconomic variables. These results support offering PTNS as standard of care to a predominantly Black population with refractory OAB.