Efficacy of Transcutaneous Electrical Nerve Stimulation in the Management of Neurogenic Overactive Bladder

Liu, Yi; Xú, Gang; Geng, Jie

doi:10.1097/phm.0000000000001836

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…In three studies, TENS was compared to sham treatment for treatment of post-ischemic stroke urinary incontinence, whereas one study compared TENS to anticholinergic drugs (64)(65)(66)(67). TENS improved symptom scores, voiding diary parameters (daily micturition, nocturia, urgent urination, and urge UI), and urodynamic findings (maximum cystometry volume, flow rate, pressure of detrusor in the end of the filling phase).…”

Section: Transcutaneous Electrical Nerve Stimulation (Tens)mentioning

confidence: 99%

Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials

Bapir¹,

Bhatti

Eliwa

et al. 2022

Arch Ital Urol Androl

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Background: Overactive bladder (OAB) symptoms of frequency, urgency and urge incontinence are frequently associated with known neurological diseases like multiple sclerosis (MS), spinal cord injury (SCI), Parkinson’s disease (PD), stroke. Objective: The aim of our study was to review the efficacy of pharmacological and non-pharmacological treatments for neurogenic overactive bladder. Materials and methods: We searched two electronic databases (PubMed and EMBASE) for randomized controlled trials focusing on pharmacological and non-pharmacological medical treatments for overactive bladder symptoms associated with neurological diseases published up to 30 April 2022. Results: A total of 157 articles were retrieved; 94 were selected by title and abstract screening; after removal of 17 duplicates, 77 records were evaluated by full-text examination. Sixty-two studies were finally selected. The articles selected for review focused on the following interventions: anticholinergics (n = 9), mirabegron (n = 5), comparison of different drugs (n = 3), cannabinoids (n = 2), intravesical instillations (n = 3), botulinum toxin (n = 16), transcutaneous tibial nerve stimulation (TTNS) (n = 6), acupuncture (n = 2), transcutaneous electrical nerve stimulation TENS (n = 4), pelvic floor muscle training (PFMT) (n = 10), others (n = 2). Anticholinergics were more effective than placebo in decreasing the number of daily voids in patients with PD (mean difference [MD]- 1.16, 95 % CI - 1.80 to - 0.52, 2 trials, 86 patients, p < 0.004), but no significant difference from baseline was found for incontinence episodes and nocturia. Mirabegron was more effective than placebo in increasing the cystometric capacity in patients with MS (mean difference [MD] 89.89 mL, 95 % CI 29.76 to 150.01, 2 trials, 98 patients, p < 0.003) but no significant difference was observed for symptom scores and bladder diary parameters. TTNS was more effective than its sham-control in decreasing the number of nocturia episodes (MD -1.40, 95 % CI -2.39 to -0.42, 2 trials, 53 patients, p < 0.005) but no significant changes of OAB symptom scores were reported. PFMT was more effective than conservative advice in decreasing the ICIQ symptom score (MD, -1.12, 95 % CI -2.13 to -0.11, 2 trials, 91 patients, p = 0.03), although the number of incontinence episodes was not significantly different between groups. Conclusions: The results of the meta-analysis demonstrate a moderate efficacy of all considered treatments without proving the superiority of one therapy over the others. Combination treatment using different pharmacological and non-pharmacological therapies could achieve the best clinical efficacy due to the favorable combination of the different mechanisms of action. This could be associated with fewer side effects due to drug dosage reduction. These data are only provisional and should be considered with caution, due to the few studies included in metaanalysis and to the small number of patients.

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Section: Transcutaneous Electrical Nerve Stimulation (Tens)mentioning

confidence: 99%

Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials

Bapir¹,

Bhatti

Eliwa

et al. 2022

Arch Ital Urol Androl

View full text Add to dashboard Cite

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“…For disabled patients, who may be more sensitive to the side effects of antimuscarinics than normal patients, the expectation is to undergo therapy at home, and the transcutaneous approach TNS can make it realizable, especially in the global Coronavirus disease 2019 pandemic, patients have expressed concern about the increased probability to infection if a weekly visit is done. Of note, Liu et al confirmed that the TENS protocol applied to the neurogenic overactive bladder in their RCT was superior to anticholinergics 29 . On the other hand, no consensus is available on the acknowledged stimulation parameters and treatment duration, suggesting further research is greatly warranted.…”

Section: Discussionmentioning

confidence: 90%

“…Although there is no exact consensus on the underlying mechanisms of action of PENS 28 , the current study suggests improvements in urodynamic outcomes (MCC, MFR, MDP, VV, and PVR) and voiding diary parameters (IE and OABSS). Besides, only minimal side effect such as curable skin redness was present, which is superior to anticholinergic drugs because of common adverse events, for example dry mouth, constipation, dizziness, drowsiness, blurred vision, and even dementia later 29 . To our knowledge, this is the first study to provide reliable evidence about the effectiveness and safety of electrical nerve stimulation for treating NLUTD.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of peripheral electrical nerve stimulation on improvements of urodynamics and voiding diary in patients with neurogenic lower urinary tract dysfunction: a systematic review and meta-analysis

Fan

et al. 2023

International Journal of Surgery

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Background: Peripheral electrical nerve stimulation is a routinely recommended treatment for non-neurogenic overactive bladder but has not been approved for patients with neurogenic lower urinary tract dysfunction (NLUTD). This systematic review and meta-analysis was to elucidate the efficacy and safety of electrostimulation and thus provide firm evidence for treating NLUTD. Materials and methods: We systematically performed the literature search through PubMed, Web of Science, and Cochrane Library databases in March 2022. The eligible studies were identified across the inclusion criteria and the data on urodynamic outcomes, voiding diary parameters, and safety was collected to quantitatively synthesize the pooled mean differences (MDs) with 95% CIs. Subgroup analyses and sensitivity analyses were subsequently used to investigate the possible heterogeneity. This report was achieved in accordance with the preferred reporting items for systematic reviews and meta-analyses statement. Results: A total of 10 studies involving 464 subjects and 8 studies with 400 patients were included for systematic review and meta-analysis, respectively. The pooled effect estimates indicated that electrostimulation could significantly improve urodynamic outcomes, including maximum cystometric capacity (MD=55.72, 95% CI 15.73, 95.72), maximum flow rate (MD=4.71, 95% CI 1.78, 7.65), maximal detrusor pressure (MD=−10.59, 95% CI −11.45, −9.73), voided volume (MD=58.14, 95% CI 42.97, 73.31), and post-void residual (MD=−32.46, 95% CI −46.63, −18.29); for voiding diary parameters, patients undergoing electrostimulation showed lower MDs of incontinence episodes per 24 h (MD=−2.45, 95% CI −4.69, −0.20) and overactive bladder symptom score (MD=−4.46, 95% CI −6.00, −2.91). In addition to surface redness and swelling, no stimulation-related severe adverse events were reported else. Conclusions: The current evidence demonstrated that peripheral electrical nerve stimulation might be effective and safe for managing NLUTD, whereas more reliable data from large-scale randomized controlled trials are necessary to strengthen this concept.

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Flexible Electrodes for Brain–Computer Interface System

Wang

Liu

et al. 2023

Advanced Materials

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Brain‐computer interface (BCI) has been the subject of extensive research recently. Governments and companies have substantially invested in relevant research and applications. The restoration of communication and motor function, the treatment of psychological disorders, gaming, and other daily and therapeutic applications all benefit from BCI. The electrodes hold the key to the essential, fundamental BCI precondition of electrical brain activity detection and delivery. However, the traditional rigid electrodes are limited due to their mismatch in Young's modulus, potential damages to the human body and a decline in signal quality with time. These factors make the development of flexible electrodes vital and urgent. Flexible electrodes made of soft materials have grown in popularity in recent years as an alternative to conventional rigid electrodes because they offer greater conformance, the potential for higher signal‐to‐noise ratio (SNR) signals, and a wider range of applications. Therefore, the latest classifications and future developmental directions of fabricating these flexible electrodes are explored in this paper to further encourage the speedy advent of flexible electrodes for BCI. In summary, the perspectives and future outlook for this developing discipline are provided.This article is protected by copyright. All rights reserved

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Efficacy of Transcutaneous Electrical Nerve Stimulation in the Management of Neurogenic Overactive Bladder

Cited by 6 publications

References 24 publications

Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials

Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials

Efficacy of peripheral electrical nerve stimulation on improvements of urodynamics and voiding diary in patients with neurogenic lower urinary tract dysfunction: a systematic review and meta-analysis

Flexible Electrodes for Brain–Computer Interface System

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