Research Article| Volume 135, P40-46, May 2020

Effectiveness of transcutaneous tibial nerve stimulation at two different thresholds for overactive bladder symptoms in older women: a randomized controlled clinical trial


      • Transcutaneous tibial nerve stimulation is indicated as the first-line treatment for older women with an overactive bladder.
      • Transcutaneous tibial nerve stimulation is safe and tolerable for older women.
      • Sensory and motor thresholds of transcutaneous tibial nerve stimulation show the same effectiveness for overactive bladder.


      Objectives:To compare the effectiveness of transcutaneous tibial nerve stimulation (TTNS) at two different current amplitude thresholds (sensory and motor) in terms of urinary habit, symptoms and the degree of discomfort of overactive bladder (OAB) in older women.

      Study design

      This is a randomized, controlled, 3-arm blinded trial. One hundred and one patients attending secondary care with OAB were randomized into one of three groups: group 1, TTNS sensitivity threshold (n = 39); group 2, TTNS motor threshold (n = 33); and control group 3 (n = 29).

      Main outcome measures

      Participants allocated to groups 1 and 2 had 8 sessions of TTNS for 30 min, twice a week. Group 3 received no intervention. The results measured were the symptoms of overactive bladder (ICIQ-OAB, overall score), bother scales (to indicate the impact of individual symptoms for the patient) and urinary habit (3-day bladder diary). A blind assessor measured outcomes at baseline and 5 weeks after randomization.


      After five weeks, a statistically significant difference between group 3 (control) and group 1 (TTNS sensitivity threshold) and group 2 (TTNS motor threshold) was observed in the intergroup analysis, but no difference in the outcomes analyzed was detected between the two groups receiving intervention (groups 1 and 2).


      TTNS is effective in the treatment of OAB in older women, with no difference between the sensitivity and motor thresholds.

      Clinical trial registration number

      Registro Brasileiros de Ensaios Clínicos (RBR-39DZ5V)


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