Transcutaneous tibial nerve stimulation (TTNS) is used to treat overactive bladder (OAB) syndrome. We hypothesized that TTNS instruction delivered via telehealth (TH) would be as effective as face-to-face (FtF) instruction in improving OAB symptoms.
In this prospective cohort study, 99 women with OAB self-selected FtF (n = 79) or TH (n = 20) instruction for TTNS setup. Groups received standardized education on device placement and usage. Primary outcome was the between-group comparison of change in International Consultation on Incontinence Questionnaire (ICIQ-SF) scores at 3 and 12 months. Secondary outcomes included between-group comparisons of Patient Global Impression of Improvement (PGI-I) score at 3 months and treatment persistence at 12 months. Between-group differences were analyzed using Student's t tests.
At 3 months, FtF and TH groups showed mean ICIQ-SF score reductions of 2.3 ± 1.8 and 1.9 ± 1.6 points respectively (between-group difference 0.4 points; 95% CI -1.79, 2.59; p = 0.60). PGI-I scores indicated improvement in 48.1% of FtF and 50.0% of TH participants. At 12 months, treatment persistence was 60.8% for FtF and 55.0% for TH groups. Among continued treatment responders, sustained improvement was observed, with mean ICIQ-SF reductions of 3.6 ± 2.4 points (FtF) and 4.0 ± 2.6 points (TH) from baseline (p = 0.48). Progression to third-line therapies was comparable between groups (FtF 24.0%, TH 25.0%).
Telehealth shows promise as an effective method for initiating TTNS treatment for OAB, providing comparable outcomes with FtF instruction. The approximate 50% response rate and sustained benefits among responders support TTNS as a viable treatment. Findings support broader implementation of TH TTNS instruction, potentially improving treatment access for suitable patients.
International urogynecology journal. 2025 Dec 29 [Epub ahead of print]
Tess Nagy, Wendy Allen, Katrina Parkin, Emmanuel Karantanis, Kate H Moore, Zhuoran Chen
Pelvic Floor Unit, St. George Hospital, Gray St., Kogarah, NSW, 2217, Australia. ., Pelvic Floor Unit, St. George Hospital, Gray St., Kogarah, NSW, 2217, Australia.