Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder

Asian Journal of Urology, 2015, 2 (2): 92-101 doi:

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Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder

Martin Slovak, Christopher R. Chapple, Anthony T. Barker

1. Department of Medical Physics & Clinical Engineering, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;
2. Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

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Abstract We reviewed the literature on transcutaneous electrical nerve stimulation (TENS) used as a therapy for overactive bladder (OAB) symptoms, with a particular focus on: stimulation site, stimuli parameters, neural structures thought to be targeted, and the clinical and urodynamic outcomes achieved. The majority of studies used sacral or tibial nerve stimulation. The literature suggests that, whilst TENS therapy may have neuromodulation effects, patient are unlikely to benefit to a significant extent from a single application of TENS and indeed clear benefits from acute studies have not been reported. In long-term studies there were differences in the descriptions of stimulation intensity, strategy of the therapy, and positioning of the electrodes, as well as in the various symptoms and pathology of the patients. Additionally, most studies were uncontrolled and hence did not evaluate the placebo effect. Little is known about the underlying mechanism by which these therapies work and therefore exactly which structures need to be stimulated, and with what parameters. There is promising evidence for the efficacy of a transcutaneous stimulation approach, but adequate standardisation of stimulation criteria and outcome measures will be necessary to define the best way to administer this therapy and document its efficacy.

Key words： Overactive bladder Posterior tibial nerve stimulation Sites of stimulation Sacral stimulation Sham stimulation methodology Surface electrodes Transcutaneous electrical nerve stimulation

Published: 30 April 2015

Fund:This work was funded by the European Commission's Research and Innovation Framework programme (Marie Curie Actions Initial Training Network) for the TRUST project (Training Urology Scientists to Develop Treatments) Grant Number 238541. The study formed part of the project portfolio of the NIHR Devices for Dignity Healthcare Technology Cooperative. We would like to thank Emma Gugon for the sketch of TPTNS.

Corresponding Authors: Anthony T. Barker E-mail: m.slovak@sheffield.ac.uk

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Martin Slovak,Christopher R. Chapple,Anthony T. Barker. Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder[J]. Asian Journal of Urology, 2015, 2(2): 92-101.

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http://www.ajurology.com/EN/ OR http://www.ajurology.com/EN/Y2015/V2/I2/92

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