Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms

Seth, Jai; Gonzales, Gwen; Haslam, Collette; Pakzad, Mahreen; Vashisht, Arvind; Sahai, Amit; Knowles, Charles H.; Tucker, A.; Panicker, Jalesh N.

doi:10.21037/tau.2018.09.12

Cited by 26 publications

(30 citation statements)

References 19 publications

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“…Finally, 19 studies [ 3 , 4 , 5 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] were included. Of these, nine were experimental [ 3 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], including eight RTCs [ 3 , 17 , 18 , 19 , 20 , 21 , 22 , 24 ] ( Table 2 ); four were observational studies [ 5 , 25 , 26 , 27 ] ( Table 3 ), and six were either systematic reviews [ 4 , 29 , 31 ] or a meta-analysis [ 28 ], while two encompassed both types of studies [ 30 , 32 ] ( Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…By contrasting daily or weekly treatment [ 21 ] with TTNS, 100% of weekly participants completed the compliance and experience questionnaire, in comparison to 90.5% of patients on daily therapy [ 21 ]. Although 53% (18) gave as a result a moderate or significant improvement in symptoms for the global response assessment (GRA), 75% (13/20) of neurological patients with OAB and 36% (5/14) of patients with idiopathic OAB responded to the intervention [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review

et al. 2021

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Background: Percutaneous electrical stimulation and transcutaneous electrical stimulation (PTNS and TTNS) of the posterior tibial nerve are internationally recognized treatment methods that offer advantages in terms of treating patients with overactive bladder (OAB) who present with urinary incontinence (UI). This article aims to analyze the scientific evidence for the treatment of OAB with UI in adults using PTNS versus TTNS procedures in the posterior tibial nerve. Methods: A systematic review was conducted, between February and May 2021 in the Web of Science and Scopus databases, in accordance with the PRISMA recommendations. Results: The research identified 259 studies, 130 of which were selected and analyzed, with only 19 used according to the inclusion requirements established. The greatest effectiveness, in reducing UI and in other parameters of daily voiding and quality of life, was obtained by combining both techniques with other treatments, pharmacological treatments, or exercise. Conclusions: TTNS has advantages over PTNS as it is more comfortable for the patient even though there is equality of both therapies in the outcome variables. More research studies are necessary in order to obtain clear scientific evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review

et al. 2021

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“…Several studies have reported efficacy of TTNS on OAB patients. [21][22][23] While others have shown TTNS to compare favorably to medications, 24 Ramírez-García et al demonstrated non-inferiority between transcutaneous and percutaneous tibial nerve stimulation. 25 Another study by Martin-Garcia, et al 26 that compared PTNS to a home-based stimulation system found no statistically significant difference between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Do we need more patient‐friendly treatment options for overactive bladder (OAB)?

Gerig¹,

Cameron²,

Arora³

et al. 2021

Neurourology and Urodynamics

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Aims: To collect feedback from subjects diagnosed with overactive bladder (OAB) on its impact on their quality of life, their satisfaction with current treatment options, and to assess nonsurgical, tibial nerve stimulation as a treatment option.Methods: Subjects were asked a variety of questions about the impact of OAB on their lives, their satisfaction with current and previous treatment approaches. Subjects evaluated the comfort of a nonworking prototype garment and were given electrical stimulation over their posterior tibial nerve to assess comfort and tolerability. Electromyographic (EMG) signals were recorded.Results: A total of 40 subjects with OAB symptoms were evaluated in the study. Urgency (55%), frequency (47.5%), nocturia (40%), and incontinence (30%) were the most bothersome symptoms. At the time of the study only 32.5% of the subjects were treating their OAB symptoms. Of those that had tried and discontinued treatments, most had failed medications (n = 14) due to no improvements or side effects. Only 2 subjects found stimulation to be uncomfortable before an EMG signal could be detected. The most common word used to describe the feeling of stimulation was "constant," followed by "tingling," "vibrating," and "comfortable."Conclusions: Most subjects who had tried OAB treatments were dissatisfied and discontinued their use. A new patient-friendly approach to OAB therapy that delivers efficacy but overcomes drawbacks associated with currently available treatments is needed. Subjects found electrical stimulation over the tibial nerve to be comfortable and tolerable and this should be considered as an alternative treatment approach for OAB.

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“…Our review of the literature revealed few studies investigating TTNS among neurogenic bladder (Amarenco et al, 2003;Monteiro et al, 2014;Perissinotto et al, 2015;Valles-Antuna et al, 2017). Specific to people with MS, two experimental studies were identified (de Seze et al, 2011;Seth et al, 2018). In the uncontrolled experimental study by de Seze et al (2011), the authors recruited 70 people with MS and OAB.…”

Section: Introductionmentioning

confidence: 99%

“…The study compared two different protocol of TTNS 30 min daily vs. 30 min weekly, for 12 weeks between 24 MS participants with OAB to 24 participants with idiopathic OAB. TTNS was shown to be safe, acceptable and significant improvements in urinary symptoms including OAB were reported for both groups ( Seth et al ., 2015 ; Seth et al ., 2018 ). The electrical stimulation parameters for both groups were at 27 mA current, with 1 Hz current frequency and pulse width was between 70 and 560 µs and was consecutively increased depending upon the maximum tolerable sensory and best sensory-motor response.…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous tibial nerve stimulation for the treatment of bladder storage symptoms in people with multiple sclerosis: Protocol of a single-arm feasibility study

et al. 2020

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Background: Neurogenic lower urinary tract dysfunction (NLUTD) is common among people with multiple sclerosis (MS) with a pooled prevalence of 68.41% using self-report measures and 63.95% using urodynamic studies. Transcutaneous tibial nerve stimulation (TTNS) is a non-invasive option to manage bladder storage symptoms; however, the potential efficacy of TTNS among people with MS is based on a small number of studies with the absence of high-quality evidence relating to efficacy, and lack of clarity of the optimal electrical stimulation parameters and frequency, duration and number of treatment sessions. This study aims to assess whether TTNS is feasible and acceptable as a treatment for bladder storage symptoms in people with MS. Methods: We will use a single-arm experimental study to explore the feasibility and acceptability of TTNS in the treatment of bladder storage symptoms in MS. The CONSORT extension for pilot and feasibility studies will be followed to standardise the conduct and reporting of the study. The recruitment plan is twofold: 1) Open recruitment for people with MS through MS Ireland’s communication channels; 2) recruitment from a convenience sample of people with MS who have previously participated in a qualitative interview study of urinary symptoms. We will assess recruitment/retention rates, the urinary symptoms changes and the effect on quality of life pre and post intervention using ICIQ-OAB, 3-day bladder diary, King’s Health Questionnaire and collect self-reported data on adherence and adverse events. Acceptability of using TTNS will be evaluated at the end of intervention. This study has been reviewed and approved by the Education and Health Science’s Faculty Research Ethics Committee, University of Limerick [2020_06_07_EHS]. Conclusion: It is anticipated that assessing the feasibility and acceptability of TTNS for storage bladder symptoms in MS will inform the development of a definitive randomised trial. Trial registration: ClinicalTrials.gov NCT04528784 27/08/2020

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Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms

Cited by 26 publications

References 19 publications

Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review

Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review

Do we need more patient‐friendly treatment options for overactive bladder (OAB)?

Transcutaneous tibial nerve stimulation for the treatment of bladder storage symptoms in people with multiple sclerosis: Protocol of a single-arm feasibility study

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