Comparison of transcutaneous electrical tibial nerve stimulation for the treatment of overactive bladder: a multi-arm randomized controlled trial with blinded assessment

Abstract

To compare the effectiveness of tibial nerve transcutaneous electrical nerve stimulation (TENS) for an overactive bladder, considering the sites of application and frequency of attendance. METHODS: This multi-arm randomized controlled trial enrolled 137 adult women (61.0±9.0 years) with overactive bladder from a university hospital. They underwent 12 sessions of 30-min TENS application and were assigned to five groups: one leg, once a week (n=26); one leg, twice a week (n=27); two legs, once a week (n=26); two legs, twice a week (n=28); and placebo (n=30). Symptoms of overactive bladder and its impact on quality of life were evaluated before and after 6 or 12 weeks of treatment using the Overactive Bladder Questionnaire-V8 and voiding diary. ClinicalTrials.gov: NCT01912885. RESULTS: The use of one leg, once a week TENS application reduced the frequency of urgency episodes compared with the placebo (1.0±1.6 vs. 1.4±1.9; p=0.046) and frequency of incontinence episodes compared with the placebo (0.7 ± 1.4 vs.1.4 ± 2.2; po0.0001). The one-leg, twice a week protocol decreased the urinary frequency compared with the two legs, once a week protocol (8.2 ± 3.5 vs. 9.0 ± 5.1; p=0.026) and placebo (8.2±3.5 vs. 7.9±2.7; p=0.02). Nocturia improved using the two legs, once a week protocol (1.5±1.8) when compared with the one leg, twice a week protocol (1.9±2.0) and placebo (1.7±1.6) (p=0.005 and p=0.027, respectively). Nocturia also improved using the two legs, twice a week protocol when compared with the one leg, twice a week protocol (1.3 ± 1.2 vs.1.9 ± 2.0; p=0.011). CONCLUSION: One-leg stimulation improved the daily urinary frequency, urgency, and incontinence, and the two-leg stimulation once and twice weekly improved nocturia.

Effects of transcutaneous tibial nerve stimulation for overactive bladder symptoms in adults: A randomized controlled trial

“…We used non-invasive (transcutaneous) electrical stimulation to treat OAB symptoms and yielded good results as a previous study by Pierre and colleagues reported that invasive (percutaneous) electrical stimulation significantly treated OAB symptoms [21]. The effectiveness of TTNS in the current study established that transcutaneous application of electrical stimulation can be preferred over percutaneous stimulation for OAB symptoms because it is more comfortable for the patients.…”

“…It was also supported by the study done by Pierre ML in which they applied TTNS once a week to treat OAB symptoms. Their study showed that only once-a-week application of TTNS did not alter the outcomes of the treatment or impede the recovery of the symptoms [21].…”

The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial

“…The amplitude was adjusted to the level that produced painless paresthesia in each patient according to their tolerance. PTNS was applied for 30 min [20]. Patients who did not receive six sessions of treatment or who missed 3-to 4-day intervals were excluded from the study.…”

Physical Agent-Based Treatments for Overactive Bladder: A Review

“…Another thing to pay attention is whether stimulation is better given in one or both legs. In one study, the stimulation of one leg was adequate to relieve OAB symptoms, except for nocturia, but the best results were seen with the two-leg protocol [ 56 ]. Therefore, the use of T-TNS should be tailored to the specificity of the symptoms described by the patient.…”