- •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.
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)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Maturitas
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence.Neurourol Urodyn [Internet]. 2010; 29: 213-240
- Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction.BJU Int [Internet]. 2011; 108: 1132-1139
- A Population-based survey of lower urinary tract symptoms (LUTS) and symptom-specific bother: results from the Brazilian LUTS epidemiology study (BLUES).World J. Urol. 2013; 31: 1451-1458
- The aging overactive bladder: a review of aging-related changes from the brain to the bladder.Curr. Bladder Dysfunct. Rep. 2017; 12: 42-47
- CUA guideline on adult overactive bladder.Can. Urol. Assoc. J. 2017; 11: E142-73
- Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment.J. Urol. 2015; 193: 1572-1580
- A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care.J Am Med Dir Assoc [Internet]. 2013; 14: 270-274
- The effectiveness of transcutaneous tibial nerve stimulation (TTNS) for adults with overactive bladder syndrome: a systematic review.Neurourol Urodyn [Internet]. 2018; : 1-14
- The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS.BJU Int. 2011; 108: 1459-1471
- Management of OAB in those over age 65.Curr. Urol. Rep. 2013; 14: 379-385
- Translating overactive bladder questionnaires in 14 languages.Urology. 2006; 67: 536-540
- The vaginal profile.Tex Med J. 1968; 64: 56-58
- Validação do international consultation on incontinence questionnaire overactive bladder (ICIQ-OAB) para a língua portuguesa.Rev. Bras. Ginecol. Obstet. 2010; 32: 273-278
- Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder.J Urol [Internet]. 2003; 169: 2210-2215
- Assembléia Mundial Sobre Envelhecimento: Resolução 39/125.Viena, Áustria : Organização das Nações Unidas, 1982
- Randomized trial of transcutaneous tibial nerve stimulation to treat urge urinary incontinence in older women.Int. Urogynecol. J. 2010; 21: 1065-1070
- Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, double-blind, placebo controlled trial.J Urol [Internet]. 2010; 184: 2001-2006
- Randomized Trial of Percutaneous Tibial Nerve Stimulation Versus Sham Efficacy in the Treatment of Overactive Bladder Syndrome: Results From the SUmiT Trial.J Urol [Internet]. 2010; 183: 1438-1443
- Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study.J Urol [Internet]. 2013; 189: 2194-2201
- Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder.J Urol [Internet]. 2010; 183: 234-240
- Nocturia and quality of life.Eur. Urol. 2012; 61: 85-87
- A peripheric neuromodulation technique for curing detrusor overactivity: stoller afferent neurostimulation.Scand. J. Urol. Nephrol. 2005; 39: 230-233
- Electrical stimulation. A physiologic approach to the treatment of urinary incontinence.Urol. Clin. North Am. 1991; 18: 393-407
- Effects of external and direct pudendal nerve maximal electrical stimulation in the treatment of the uninhibited overactive bladder.Br. J. Urol. 1989; 64: 374-380
- Maximal electrostimulation of the pelvic floor in female idiopathic detrusor instability and urge incontinence.Neurourol. Urodyn. 1989; 8: 219-227
- Short-term electrical stimulation: home treatment for urinary incontinence.World J. Urol. 1986; 4: 24-26
- Maximal external electrical stimulation for treatment of neurogenic or non-neurogenic urgency and/or urge incontinence.Neurourol. Urodyn. 1996; 15: 187-194
Published online: February 24, 2020
Accepted: February 23, 2020
Received in revised form: October 1, 2019
Received: July 10, 2019
© 2020 Elsevier B.V. All rights reserved.