Background:

Overactive bladder treatment includes lifestyle changes, physical therapy, anticholinergics, neuromodulation, and botulinum toxin. Due to treatment refractoriness, there has been increasing interest in peripheral neuromodulation. Our aim was to evaluate the efficacy of transcutaneous vs percutaneous tibial nerve stimulation in non-neurogenic overactive bladder.

Material and Methods:

A randomized clinical trial was conducted on 61 patients, within the time frame of January-October 2019. The patients were divided into two groups: transcutaneous (n=33) and percutaneous (n=28). The stimulator (BioTENS) was utilized at 10 Hz/200 us to apply 12 20-minute sessions. Efficacy was evaluated through a 3-day bladder diary, symptom and quality of life questionnaire, and treatment benefit scale in sessions 1, 6, and 12. Descriptive statistics and correlation of variables were performed using the SPSS v22.0 program, and statistical significance was set at a p ≤ 0.05.

Results:

Mean patient age was 66 years. Diurnal and nocturnal urinary frequency decreased, mean urinary volume increased, and the number of urgency and urge incontinence episodes decreased, with no statistically significant differences between the two treatments. The perception of quality of life and improvement related to treatment increased positively with both techniques (p≥0.05). There were no side effects and treatment adherence was 83.6 % (n=51). A lower intensity level was employed in the percutaneous treatment (4 mA vs 7 mA; p=0.0001).

Conclusions:

Non-inferiority was demonstrated in this first randomized clinical trial conducted in Mexico that evaluated the efficacy of the two techniques.