Overactive bladder (OAB) is characterized by urgency with or without incontinence. ICS recognize percutaneous (using a needle) tibial nerve stimulation as a third line therapy for Overactive bladder (OAB) treatment. Transcutaneous tibial nerve stimulation (TTNS) is a non invasive method that could delivery same energy without being invasive and could be applied as first line therapy.  However, there are few studies with TTNS. The present study aims to evaluate TTNS in OAB women.

From November 2016 to January 2019 women> 18 years old, with complaints of BH (dry and wet) who failed conservative treatment were included in a prospective study after signing the informed consent form. Patients with previous urological surgery, previous unsuccessful physiotherapy, neurological disease, pregnant women, with severe cognitive impairment, psychiatric diagnosis, urethral vesicular fistulas, grade III prolapse, calculi, urethral cysts and bladder cancer, patients who did not want to start the program were excluded . All women were evaluated before and after treatment through clinical history, a questionnaire on urinary symptoms (International Consult on Incontinence Questionnaire - Short Form; hyperactive bladder questionnaire) is a simple, brief and self-administered questionnaire, chosen to be translated and adapted to our culture by quickly assessing the impact of UI on quality of life and qualifying the urinary loss of patients of both sexes. and World Health Organization Questionnaires for Quality of Life (WHOQoL-Brief) an abbreviated version of the WHOQOL-100, developed and recommended by the World Health Organization (WHO), values ​​individual perception, being able to assess QOL in different groups and situations , regardless of educational level. The intervention was performed through twelve TTNS sessions twice a week, for 20 minutes. The electrical parameter applied was balanced symmetrical biphasic current (10 Hz with 200 µs, Wobb = 50%). The positioning of the electrodes was similar to that of percutaneous stimulation. the positioning of the electrodes can be seen in Fig. 1.

A total of 48 women with mean age of 60 years old (SD ± 14.79) were included.

After treatment, patients had an significant (p<0.001) improvement in ICI-Q and OABq scores (Table 1). TTNS presented significant  positive impact on physical (p = 0.012) and psychological (p = 0.021) domain of  WHOQoL-Brief. Out of the 48 patients, 19 women (40%) present an improvement greater than 50% in symptom’s score and pad test.

TTNS seems to be an alternative to the treatment of female OAB. Transcutaneous tissue makes tibial nerve stimulation easier to perform, non-invasive, can be easily handled at home by the patient and can be applied as first-line therapy before medications, and unlike other treatments, the patients attended did not report side effects.