Faculty, Staff and Student Publications

Language

English

Publication Date

12-1-2024

Journal

Journal of Urology

DOI

10.1097/JU.0000000000004189

PMID

39093916

PMCID

PMC11560598

PubMedCentral® Posted Date

12-1-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Purpose: Our goal was to evaluate if self-administered bladder neuromodulation with transcutaneous tibial nerve stimulation could safely replace overactive bladder medications in people with spinal cord injury.

Materials and methods: We performed a 3-month, randomized, investigator-blinded, tibial nerve stimulation vs sham-control trial in adults with spinal cord injury and neurogenic bladder performing intermittent catheterization and taking overactive bladder medications. The primary outcome was a reduction in bladder medications while maintaining stable bladder symptoms and quality of life based on pre/post Neurogenic Bladder Symptom Score and the Incontinence Quality of Life questionnaire, respectively. Secondary outcomes included changes in pre/post cystometrogram, 2-day voiding diaries, and an anticholinergic medication side effect survey.

Results: Fifty people consented to the study, with 42 completing the trial. No dropouts were due to stimulation issues. All baseline demographics and surveys were comparable at baseline. Cystometrogram parameters were also comparable at baseline, except the stimulation group had a higher proportion of loss of bladder compliance compared to the control group. At the end of the trial, a significantly greater percentage of the tibial nerve stimulation group was able to reduce medications (95% vs 68%), by a 26.2% difference in medication reduction (95% CI 1.17%-51.2%). Function and quality of life surveys and cystometrograms at the end of the trial were alike between groups. Transcutaneous tibial nerve stimulation satisfaction surveys and adherence to protocol were high.

Conclusions: In people with chronic spinal cord injury performing intermittent catheterization, transcutaneous tibial nerve stimulation can be an option to reduce or replace overactive bladder medications.

Keywords

Humans, Spinal Cord Injuries, Urinary Bladder, Overactive, Female, Male, Transcutaneous Electric Nerve Stimulation, Tibial Nerve, Middle Aged, Adult, Single-Blind Method, Urinary Bladder, Neurogenic, Quality of Life, Self Care, Urinary Bladder, Neurogenic; Tibial Nerve; Spinal Cord Injuries; Transcutaneous Electric Nerve Stimulation, Cholinergic Antagonists

Comments

Trial registration: ClinicalTrials.gov NCT03458871.

Published Open-Access

yes

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