COMPARISON OF THE EFFECTS OF DIFFERENT PARASACRAL TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION PROTOCOLS IN WOMEN WITH OVERACTIVE BLADDER

Year 2025, Volume: 35 Issue: 6, 1280 - 1290, 31.12.2025

Zehra Korkut , Merve Başol Göksülük , Arif Aydın , Şeyda Toprak Çelenay

https://doi.org/10.54005/geneltip.1743348

https://izlik.org/JA98UG56DY

Abstract

Aim: To compare the effects of different parasacral transcutaneous electrical nerve stimulation (TENS) protocols on bladder function, overactive bladder (OAB) symptoms, quality of life and perception of subjective improvement (PSI) in women with OAB.
Methods: Twenty-nine women with OAB were randomly divided into 2 groups: once session TENS per week (group 1, n=13), three sessions TENS per week (group 2, n=16). Bladder function with a 3-day bladder diary, OAB symptoms with Overactive Bladder Questionnaire-Version 8 (OAB-V8) and Patients’ Perception of Intensity of Urgency Scale (PPIUS), quality of life with the King’s Health Questionnaire (KHQ) were evaluated at pre-intervention, mid-term (3th week) and post-intervention. PSI were evaluated with Likert type scale at post-intervention.
Results: Significant decrease was observed in the average number of voids/day and PPIUS scores in both groups (p<0.05). There was a greater decrease in OAB-V8 score in group 2 (p<0.05). No significant decrease was observed in KHQ scores of group 1 (p>0.05), however, improvement was observed scores of group 2 (p<0.05). In intergroup comparisons, a greater decrease was detected in OAB-V8, PPIUS and KHQ scores in group 2 compared to group 1 (p <0.05) (Table 1). A greater increase was found in PSI scores in group 2 compared to group 1 (p<0.05).
Conclusions: Parasacral TENS applied three sessions per week was more effective than once session per week in improving bladder function, OAB symptoms, quality of life, and PSI score. It can be recommended to patients with OAB.

Keywords

Overactive bladder , transcutaneous electric nerve stimulation , bladder function , quality of life

AŞIRI AKTİF MESANESİ OLAN KADINLARDA FARKLI PARASAKRAL TRANSKUTANÖZ ELEKTRİK SİNİR STİMULASYONU PROTOKOLLERİNİN ETKİLERİNİN KARŞILAŞTIRILMASI

https://izlik.org/JA98UG56DY

Abstract

Amaç: Farklı parasakral transkutanöz elektriksel sinir stimülasyonu (TENS) protokollerinin AAM’li kadınlarda mesane fonksiyonu, aşırı aktif mesane (AAM) semptomları, yaşam kalitesi ve subjektif iyileşme algısı (SİA) üzerindeki etkilerini karşılaştırmak.
Gereç ve Yöntemler: Yirmi dokuz AAM’li kadın rastgele 2 gruba ayrıldı: haftada bir seans TENS (grup 1, n=13), haftada üç seans TENS (grup 2, n=16). Mesane fonksiyonu 3 günlük mesane günlüğü ile, AAM semptomları Aşırı Aktif Mesane Anketi-Versiyon 8 (AAM-V8) ve Hasta Sıkışma Hissi Ciddiyet Algısı Ölçeği (HSHCAÖ) ile, yaşam kalitesi King Sağlık Anketi (KSA) ile müdahale öncesi, orta dönem (3. hafta) ve müdahale sonrası değerlendirildi. Likert tipi ölçek ile SİA müdahale sonrasında değerlendirilmiştir.
Bulgular: Her iki grupta da ortalama işeme sayısı/gün ve HSHCAÖ skorlarında anlamlı azalma gözlendi (p<0.05). Grup 2’de AAM-V8 skorunda azalma saptandı (p<0.05). Grup 1’in KSA skorlarında anlamlı bir düşüş gözlenmezken (p>0.05), grup 2’nin skorlarında iyileşme gözlenmiştir (p<0.05). Gruplar arası karşılaştırmalarda, grup 2’de AAM-V8, HSHCAÖ ve KSA skorlarında grup 1’e kıyasla daha fazla düşüş tespit edilmiştir (p<0.05) (Tablo 1). SİA skorlarında grup 2’de grup 1’e kıyasla daha fazla artış saptanmıştır (p<0.05).
Sonuçlar: Haftada üç seans uygulanan parasakral TENS, mesane fonksiyonlarını, AAM semptomlarını, yaşam kalitesini ve SİA’yı iyileştirmede bir seans uygulamaya göre daha etkilidir. AAM’li hastalara önerilebilir.

Keywords

Aşırı aktif mesane , transkütanöz elektrik sinir stimülasyonu , mesane fonksiyonu , yaşam kalitesi

References

• 1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardization of terminology in lower urinary tract function: Report from the standardization sub-committee of the international continence society. Urology. 2003; 61: 37–49.
• 2. Cameron AP, Chung DE, Dielubanza EJ, Enemchukwu E, Ginsberg DA, Helfand BT, et al. The AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder. J Urol. 2024; 212:11-20. 3. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29: 4-20.
• 4. Andersson KE, Hedlund P. Pharmacologic perspective on the physiology of the lower urinary tract. Urology 2002; 60: 13–21.
• 5. Pratt TS, Suskind AM. Management of overactive bladder in older women. Curr Urol Rep. 2018; 19: 92.
• 6. Pinggera G-M, Mitterberger M, Steiner E, Pallwein L, Frauscher F, Aigner F, et al. Association of lower urinary tract symptoms and chronic ischaemia of the lower urinary tract in elderly women and men: Assessment using colour Doppler ultrasonography. BJU Int. 2008; 102: 470–474.
• 7. Lightner DJ, Gomelsky A, Souter L, Vasavada SP. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment 2019. J Urol. 2019; 202: 558-563.
• 8. Celenay ST, Karaaslan Y, Coban O, Oskay K. A comparison of Kinesio taping and external electrical stimulation in addition to pelvic floor muscle exercise and sole pelvic floor muscle exercise in women with overactive bladder: a randomized controlled study. Disabil Rehabil. 2022; 44: 5124-5132.
• 9. Arruda RM, Castro RA, Sousa GC, Sartori MG, Baracat EC, Girão MJ. Prospective randomized comparison of oxybutynin, functional electrostimulation, and pelvic floor training for treatment of detrusor overactivity in women. Int Urogynecol J Pelvic Floor Dysfunct.2008;19: 1055–1061.
• 10. Stewart F, Gameiro LF, El Dib R, Gameiro MO, Kapoor A, Amaro JL. Electrical stimulation with non-implanted electrodes for overactive bladder in adults. Cochrane Database SystRev. 2016; 12: CD010098.
• 11. Li M, Zhang N, Wu D, Jiang M, You S, Jia Y. Electric nerve stimulation for overactive bladder: an umbrella review. Int J Rehabil Res. 2021 ;44: 298-306.
• 12. Scaldazza CV, Morosetti C, Giampieretti R, Lorenzetti R, Baroni M. Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study. Int Braz J Urol. 2017; 43: 121-126.
• 13. Sonmez R, Yildiz N, Alkan H. Efficacy of percutaneous and transcutaneous tibial nerve stimulation in women with idiopathic overactive bladder: A prospective randomised controlled trial. Ann Phys Rehabil Med. 2022; 65: 101486.
• 14. Sharma N, Rekha K, Srinivasan KJ. Efficacy of Transcutaneous Electrical Nerve Stimulation in the Treatment of Overactive Bladder. J Clin Diagn Res. 2016;10: QC17-QC20.
• 15. Huang J, Fan Y, Wang D, Deng Q, Zou X, Yu J. Efficacy and safety of vaginal electrical stimulation as an alternative or adjunct treatment for overactive bladder syndrome in women: a meta-analysis of randomized controlled trials. Int Urogynecol J. 2023; 34: 2345-2357.
• 16. Levin MF, Hui-Chan CW. Conventional and acupuncture-like transcutaneous electrical nerve stimulation excite similar afferent fibers. Arch Phys Med Rehabil. 1993; 74: 54–60.
• 17. Quintiliano F, Veiga ML, Moraes M, Cunha C, de Oliveira LF, Lordelo P, et al. Transcutaneous parasacral electrical stimulation vs oxybutynin for the treatment of overactive bladder in children: a randomized clinical trial. J Urol. 2015; 193: 1749-53.
• 18. Gomaa MD, AbdAllah HA, Ismail IY, Wasfy IS, Sherief MH. Outcomes of para-sacral transcutaneous electric nerve stimulation in treatment of primary and refractory overactive bladder among children. Int Urol Nephrol. 2024; 56: 2475-2482.
• 19. Bright E, Cotterill N, Drake M, Abrams P. Developing and validating the International Consultation on Incontinence Questionnaire bladder diary. Eur Urol. 2014;66:294-300.
• 20. Tarcan T, Mangır N, Özgür MÖ, Akbal C. OAB-V8 Aşırı aktif mesane sorgulama formu validasyon çalışması. Üroloji Bülteni. 2012; 21: 113–6.
• 21. Cartwright R, Srikrishna S, Cardozo L, Robinson D. Validity and reliability of the patient's perception of intensity of urgency scale in overactive bladder. BJU Int. 2011; 107: 1612-7.
• 22. Kaya S, Akbayrak T, Toprak Çelenay Ş, Dolgun A, Ekici G, Beksaç S. Reliability and validity of the Turkish King's Health Questionnaire in women with urinary incontinence. Int Urogynecol J. 2015; 26: 1853-9.
• 23. Korkut Z, Turen Demir E, Toprak Celenay S. Effects of interferential current stimulation in women with pelvic organ prolapse: a prospective randomized sham-controlled study. Int Urogynecol J. 2023; 34: 279–289.
• 24. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.
• 25. Wang AC, Chih SY, Chen MC. Comparison of electric stimulation and oxybutynin chloride in management of overactive bladder with special reference to urinary urgency: a randomized placebo-controlled trial. Urology. 2006; 68: 999-1004.
• 26. Weil EH, Ruiz-Cerdá JL, Eerdmans PH, Janknegt RA, Bemelmans BL, van Kerrebroeck PE. Sacral root neuromodulation in the treatment of refractory urinary urge incontinence: a prospective randomized clinical trial. Eur Urol. 2000; 37:161-71.
• 27. Koch L, Jansen L, Herrmann A, Stegmaier C, Holleczek B, Singer S, et al. Quality of life in long-term breast cancer survivors - a 10-year longitudinal population-based study. Acta Oncol. 2013;52(6):1119-28.