Randomized trial of transcutaneous tibial nerve stimulation to treat overactive bladder in older women

Clinical Snapshot

Key Findings

• P Value: Significance reported but specific p-values not provided

• Effect Size: Not reported

• Primary Outcome: Both groups showed significant reduction in quality of life impact (ICIQ-OAB)

• Nnt Or Sensitivity: Not calculable from available data

• Confidence Interval: Not reported

Clinical Application

TTNS devices are available and treatment appears well-tolerated; requires trained personnel for implementation TTNS may be available through physiotherapy services; not currently PBS-listed but represents cost-effective adjunct to behavioral therapy for OAB management Older women with overactive bladder syndrome seeking non-pharmacological treatment options

Abstract

OBJECTIVES: To evaluate the effects of transcutaneous tibial nerve stimulation (TTNS) associated with behavior therapy (BT) compared to BT alone in the treatment of Overactive Bladder Syndrome (OAB) in older women. STUDY DESIGN: Randomized controlled clinical trial in two groups, G1 that received BT (n = 19) and G2 with the addition of TTNS (n = 19). MAIN OUTCOME MEASURES: The variables analyzed were impact on quality of live (QOL) and degree of discomfort of the symptoms of OAB by International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and voiding habit by a 3-day voiding diary (VD). The assessments were conducted at the beginning and the end of the treatment. RESULTS: Both groups showed a significant reduction in the impact of QOL by ICIQ-OAB. The G1 (BT) reduced the discomfort of nocturia symptoms and urgency urinary incontinence, while in G2 (BT+TTNS), it just did not present a reduction in the discomfort of urinary frequency by ICIQ-OAB. In the VD, despite G1 presenting an episode reduction of urgency urinary incontinence and nocturia, it showed no significant difference. In the G2, the same variables had significant reduction. CONCLUSION: Behavioral therapy reduced OAB symptoms and discomfort in older women, but its combination with TTNS led to greater improvements, particularly in urgency and nocturia. TTNS was safe, well tolerated, and enhanced quality of life, although further studies with larger samples and longer follow-up are warranted. No adverse events or complications were observed, supporting the safety and tolerability of TTNS in older women with OAB.

References

1. 1.D'Alessandro Barbosa, M., Vale, M., Gomide, L. B., Garcia, P. A., Bradaschia, J. S., da Silva, M. L., Pereira, E. C. L., & Alves, A. T. (2026). Randomized trial of transcutaneous tibial nerve stimulation to treat overactive bladder in older women. PLoS One. https://doi.org/10.1371/journal.pone.0322508