To evaluate the effects of bilateral transcutaneous tibial nerve stimulation using various parameters—low-frequency (TTNS-LF), high-frequency (TTNS-HF), Aussie Medium-Frequency (AMF), Interferential Medium-Frequency (IMF), and High-Voltage (HV)—on symptom reduction, severity of UUI symptoms, quality of life, treatment satisfaction, and discomfort. Additionally compare whether there is a superiority of the effect between parameters.
This double-blind randomized clinical trial included 123 women with UUI, who were equally allocated into five groups: TTNS-LF (n=25), TTNS-HF (n=24), AMF (n=25), IMF (n=25), and HV (n=24). All participants provided informed consent (Trial Registration: RBR-8bkkp6). Treatment consisted of 30-minute sessions, twice weekly, over 20 sessions, with stimulus intensity set just below the pain threshold or motor level. Patients were evaluated by OAB severity, symptoms and quality of life using validated questionnaires (ICIQ-SF, ICIQ-OAB, OAB-V8, ISI) at baseline and during the tenth and twentieth sessions. The significance level set at 5%.
Significant improvements were observed in incontinence severity, symptoms, and quality of life across all groups, particularly during the first half of the treatment. The ICIC-SF score (UI severity and quality of life), decreased significantly by the tenth session (p0.0022), with sustained improvement through the twentieth session; only the HV group maintained significant gains until the end of the protocol. The OAB-V8 score (impact of OAB symptoms) also improved significantly in the first half (p0.0022), except for TTNS-HF, which continued to show positive results (p0.0006). All groups reported significant symptom reductions in ICIQ-OAB (OAB symptom severity) (p0.0001) by the tenth session, though the AMF group did not sustain these improvements. All patients showed positive results in ISI (severity of UI) from the tenth session onward (p0.005). No superiority was found among the different electrical currents.
This trial demonstrates that low and medium-frequency transcutaneous tibial nerve stimulation effectively reduce symptoms of UUI, with more significant improvements observed early in treatment and sustained through the tenth week. Additional benefits were only seen in the HV group for reducing UI symptoms and in the TTNS-HF group for OAB severity in subsequent sessions. The results suggest that electrotherapy could be optimized to maximize early benefits without the need for prolonged additional sessions.
This study will help in making the best treatment choices for UUI by demonstrating that electrotherapy can effectively reduce acute symptoms without the need for prolonged sessions, improving quality of life. For longer-term treatment, combining electrotherapy with other therapeutic approaches may enhance outcomes. The findings support patient-centered UUI management in physiotherapy practice.
Urinary Incontinence, Urge
Transcutaneous Electric Nerve Stimulation
