Comparison of Transcutaneous Tibial Nerve Stimulation (TTNS) Protocols for Women with Refractory Overactive Bladder (OAB): a Prospective Randomized Trial.

Alkış, Okan; Sevim, Mehmet; Kartal, İbrahim Güven; Başer, Aykut; İvelik, Halil İbrahim; Aras, Bekir

OBJECTIVES Transcutaneous Tibial Nerve Stimulation (TTNS) is a non-invasive method used in OAB treatment. Purpose of this study is to compare the effectiveness of the TTNS procedure applied once a week and three times a week in women diagnosed with wet type refractory OAB. METHODS A total of 60 patients diagnosed with wet type OAB that was refractory to medical treatment were included in the study. Participants were equally and randomly divided into two groups: TTNS treatment was performed with a duration of 30 minutes for 12 weeks, once a week to Group-I and three times a week to Group-II. Pre and post-treatment OAB-V8/ICIQ-SF scores and voiding frequencies recorded in the bladder diary were compared between groups. RESULTS Four patients in Group-1 and eight in Group-2 left the study without completing the treatment. TTNS was performed in both groups for 12 weeks. There was a significant decrease in the voiding frequency, OAB-V8, ICIQ-SF scores in both group-1 and group-2 (p<0.001). A significant decrease in the OAB-V8 score was observed in the 5th week in Group-1, and in the 3rd week in Group-2. Complete response was observed in 6 patients (23.1%) in Group-1 after 12 weeks of TTNS procedure. In Group-2, 10 patients (45.5%) had a complete response. After the 12-week TTNS procedure, no significant difference was observed between the groups in terms of treatment response. CONCLUSION TTNS can be safely used before invasive treatments in resistant OAB. TTNS procedure three times a week seems more effective than performing it once a week.