In a nutshell
This study investigated the effectiveness of transcutaneous tibial nerve stimulation (TTNS) for treating adults with overactive bladder (OAB). The authors concluded that TTNS is a safe and effective non-invasive intervention for OAB in adults.
Some background
Overactive bladder (OAB) symptoms affect millions of people worldwide. The most common symptom is a sudden need or urge to urinate, often leading to incontinence (leakage of urine). OAB has a significant effect on a person’s quality of life and overall well-being, as it can interrupt day-to-day living, work, social activities and even sleep.
Lifestyle changes and behavioral interventions such as bladder and pelvic muscle training are the usual first-line therapies. Medications can be used to relax the bladder muscle to prevent it from contracting, reducing the urge to urinate. More invasive treatments include botox injections or electrical stimulation of the nerves in the lower back.
Transcutaneous tibial nerve stimulation (TTNS) involves stimulating a nerve at the back of the ankle. This non-invasive and convenient therapy has been under the focus of recent research.
Methods & findings
This study analyzed data from 13 trials, including a total of 629 participants. Transcutaneous tibial nerve stimulation (TTNS) was compared to sham (fake) treatment, standard drug therapy, sacral nerve stimulation, muscle training, or no treatment.
Overall, nine studies reported significant improvement of symptoms in 48–93% of participants who received TTNS treatment. In three studies, 25–45% of participants reported being cured of urinary incontinence (leaking of urine). Compared to sham procedure, TTNS was associated with significant improvement in reported OAB symptoms.
Two trials noted a greater improvement in symptoms with TTNS than with pelvic muscle training. Four different trials showed that TTNS was as effective at relieving OAB symptoms as standard anti-muscarinic drug treatment. Several trials reported that TTNS combined with anti-muscarinic drugs was more effective than TTNS alone.
TTNS was also effective in cases of neurogenic bladder (such as in post-stroke, spinal cord injury and multiple sclerosis patients). In patients with spinal cord injury, one study showed TTNS treatment was as effective as anti-cholinergic drugs. Another trial showed daily TTNS sessions improved bladder function in adults with multiple sclerosis and persistent OAB symptoms.
No significant side effects were reported with use of TTNS.
The bottom line
The authors concluded that TTNS is a safe, effective, and non-invasive intervention for OAB in adults.
The fine print
The studies analyzed here had small participant populations, with a mix of symptoms and TTNS treatment dosages. The outcomes being measured also varied. Follow-up was also limited in most of the studies. These issues limit the conclusions that may be drawn from these results. Further studies are needed to confirm these results, particularly for elderly patients. Long-term regimens, including stimulation dosage, also need further investigation.
What’s next?
Talk to your doctor about the potential benefits of transcutaneous tibial nerve stimulation (TTNS) for overactive bladder.
Published By :
Neurourology and urodynamics
Date :
Jul 21, 2017
