Comparing the effects of different physical and rehabilitation therapies in women with overactive bladder

The study compared the effects of different physical and rehabilitation therapies in women with overactive bladder (OAB). The study found that percutaneous tibial nerve stimulation (PTNS) alone, a combination of bladder training (BT) with electrical stimulation (ES), and a combination of BT and ES with biofeedback (BF) were effective for the treatment of OAB.

An overactive bladder (OAB) is when the muscle of the bladder is too active. An OAB is referred to as a sense of urgency with or without incontinence (involuntary leakage of urine). It is usually accompanied by frequency and nocturia. Nocturia refers to frequent waking up at night to urinate. OAB significantly interferes with a patient’s overall quality of life.

The current treatment for OAB is a combination of medications, injections, sacral neuromodulation, PTNS, and surgery. PTNS is when the tibial (calf) nerves of the leg that are responsible for bladder control are stimulated with electrical impulses. Medications usually result in unpleasant side effects and surgery is reserved as the last resort of treatment. Physical and rehabilitation therapies are also options to explore but research is insufficient.

The study analyzed 12 studies with a total of 637 patients with OAB. The studies included 112 patients treated with PTNS, 20 patients with pelvic floor muscle training (PFMT), 87 patients with transcutaneous stimulation of the tibial nerve (TTNS), 19 patients with PFMT + TTNS, 30 patients with PFMT + ES, 101 patients with BT, 16 patients with BF + BT, 46 patients with BF + ES, 16 patients with BF + BT + ES, 16 patients with acupuncture, 58 patients with sacral nerve stimulation (SNS), and 35 patients with BT + magnetic stimulation.

PTNS alone, a combination of BT + ES, and a combination of BT + ES + BF were effective therapies in relieving symptoms of an OAB. There was no significant difference between PTNS, BT + ES, and BT + ES + BF.

The study concluded that different physical and rehabilitation therapies such as PTNS and combined therapies of BF + ES, and BT + ES+ BF are effective in treating women with an OAB.

The sample size was small and the duration of the intervention was short. A larger study with a longer duration of the intervention is needed for more conclusive results.