Three randomized trials measured the effectiveness of tibial nerve stimulation to treat overactive bladder symptoms. One of the trials tested percutaneous nerve stimulation, had sham control and suggested a small benefit on overactive bladder symptoms on OAB-q scale «Peters KM, Carrico DJ, Perez-Marrero RA, et al. Ra...»1. Two of the trials measured the impact of transcutaneous nerve stimulation compared to no intervention and suggested a moderate to large impact on overactive bladder symptoms «Teixeira Alve A, Azevedo Garcia P, Henriques Jácom...»2, «Schreiner L, Nygaard CC, Dos Santos TG, et al. Tra...»3.
The level of evidence was downgraded due to high risk of bias.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| MA=Meta-analysis | |||||
| «Peters KM, Carrico DJ, Perez-Marrero RA, et al. Ra...»1 | RCT | Women with Overactive Bladder symptoms | PTNS vs sham | OAB-q | moderate |
| «Teixeira Alve A, Azevedo Garcia P, Henriques Jácom...»2 | RCT | Women with Overactive Bladder symptoms (daily urge incontinence episodes) | Three arms: TTNS with sensory and TTNS with motor vs no treatment. | Number of urge incontinence episodes, ICIQ-OAB | high |
| «Schreiner L, Nygaard CC, Dos Santos TG, et al. Tra...»3 | RCT | Women with Urge incontinence (daily urinary frequency) – age > 60 years. | Kegel exercises and bladder retraining were performed alone or in combination with TTNS | SUI and UUI episodes per 72h, ICIQ-SF | high |
| Reference | Comments |
|---|---|
| «Peters KM, Carrico DJ, Perez-Marrero RA, et al. Ra...»1 | Risk of bias: Randomization probably ok, concealment not reported Blinding ok Dropouts less than 10% Outcomes badly reported |
| «Teixeira Alve A, Azevedo Garcia P, Henriques Jácom...»2 | Risk of bias: Randomization probably ok No blinding |
| «Schreiner L, Nygaard CC, Dos Santos TG, et al. Tra...»3 | Risk of bias: Randomization probably ok No blinding, outcome assessors probably blinded Dropouts under 10% |
Results
| Reference | Number of patients (I/C) | Follow-up time | Mean (SD) I | Mean (SD) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate The level of evidence was downgraded one level due to study limitations and imprecision *Calculated from the summary measures I=intervention; C=comparison; CI=confidence interval |
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| «Peters KM, Carrico DJ, Perez-Marrero RA, et al. Ra...»1 | 101/102 | 13 weeks | -36.7 (21.5) | -29.2 (20.0) | -7.5 (-1.8 to -13.2)* |
| Reference | Number of patients (I/C) | Follow-up time | Mean (SD) I | Mean (SD) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate The level of evidence was downgraded one level due to study limitations and imprecision I=intervention; C=comparison; CI=confidence interval |
|||||
| «Peters KM, Carrico DJ, Perez-Marrero RA, et al. Ra...»1 | 103/105 | 13 weeks | 34.2 (21.3) | 26.0 (20.6) | 8.2 (2.5 to 13.9) |
| Reference | Number of patients (I/C) | Follow-up time | Mean (SD) I | Mean (SD) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: low The level of evidence was downgraded due to study limitations and imprecision * Pooled 3.68 (2.62) **Calculated from the summary measures I=intervention; C=comparison; CI=confidence interval |
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| «Teixeira Alve A, Azevedo Garcia P, Henriques Jácom...»2 | 33/30/25 | 4 weeks | 3.48 (2.45) 3.90 (2.82)* |
8.60 (3.24) | -4.92 (-3.60 to -6.24)** |
| Reference | Number of patients (I/C) | Follow-up time | Mean (SD) I | Mean (SD) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: low The quality of evidence was downgraded due to high risk of bias. *pooled 0.50 (1.26) I=intervention; C=comparison; CI=confidence interval |
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| «Teixeira Alve A, Azevedo Garcia P, Henriques Jácom...»2 | 33/30/25 | 4 weeks | 0.26 (0.54) 0.77 (1.72)* |
1.82 (1.60) | -1.32 (-0.68 to -1.96) |
| «Schreiner L, Nygaard CC, Dos Santos TG, et al. Tra...»3 | 51/50 | 16 weeks | 0.6 (0.9) | 1.63 (1.2) | -1.03 (-0.61 to -1.44) |