TTNS plus behavior therapy reduces urgency and nocturia in older women with OAB

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PloS one Published April 8, 2026 Medically reviewed April 26, 2026 Study authors: D'Alessandro Barbosa Marianna Vale, Matheus Liana Barbaresco Gomide, Garcia Patrícia Azevedo, Bradas… PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider TTNS with BT for OAB symptom reduction in older women, but evidence is from a small, short-term trial.

A randomized controlled trial enrolled 38 older women with Overactive Bladder Syndrome (OAB) to compare behavior therapy (BT) alone versus BT combined with transcutaneous tibial nerve stimulation (TTNS). Assessments using the ICIQ-OAB questionnaire and a 3-day voiding diary were conducted at the beginning and end of treatment.

Both treatment groups showed a significant reduction in the impact of OAB on quality of life. For specific symptom discomfort, BT alone reduced discomfort from nocturia and urgency incontinence, while BT+TTNS did not show a reduction in discomfort from urinary frequency. On the voiding diary, BT+TTNS led to a significant reduction in episodes of urgency urinary incontinence and nocturia, whereas BT alone showed a non-significant reduction in these episodes. Exact numerical data and effect sizes were not reported.

The intervention was safe and well-tolerated, with no observed adverse events or complications. Key limitations include the very small sample size (n=38), short follow-up period, and lack of reported absolute numbers and statistical measures for most outcomes. The authors note that further studies with larger samples and longer follow-up are warranted. For practice, this provides preliminary evidence that adding TTNS to BT may offer additional benefit for specific OAB symptoms in this population, but the evidence remains limited.

Study Details

Study typeRct

EvidenceLevel 2

PublishedJan 2026

PMID41941428

View Original Abstract ↓

OBJECTIVES: To evaluate the effects of transcutaneous tibial nerve stimulation (TTNS) associated with behavior therapy (BT) compared to BT alone in the treatment of Overactive Bladder Syndrome (OAB) in older women. STUDY DESIGN: Randomized controlled clinical trial in two groups, G1 that received BT (n = 19) and G2 with the addition of TTNS (n = 19). MAIN OUTCOME MEASURES: The variables analyzed were impact on quality of live (QOL) and degree of discomfort of the symptoms of OAB by International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and voiding habit by a 3-day voiding diary (VD). The assessments were conducted at the beginning and the end of the treatment. RESULTS: Both groups showed a significant reduction in the impact of QOL by ICIQ-OAB. The G1 (BT) reduced the discomfort of nocturia symptoms and urgency urinary incontinence, while in G2 (BT+TTNS), it just did not present a reduction in the discomfort of urinary frequency by ICIQ-OAB. In the VD, despite G1 presenting an episode reduction of urgency urinary incontinence and nocturia, it showed no significant difference. In the G2, the same variables had significant reduction. CONCLUSION: Behavioral therapy reduced OAB symptoms and discomfort in older women, but its combination with TTNS led to greater improvements, particularly in urgency and nocturia. TTNS was safe, well tolerated, and enhanced quality of life, although further studies with larger samples and longer follow-up are warranted. No adverse events or complications were observed, supporting the safety and tolerability of TTNS in older women with OAB.