Comparison of Magnetic and Transcutaenous Tibial Nerve Stimulation Added to Bladder Training for Overactive Bladder - A Randomized Controlled Trial

Q: What is the study’s main objective and hypothesis?

The study compares the efficacy of MStim and TTNS, both combined with bladder training (BT), for women with idiopathic overactive bladder. The hypothesis is that adding either stimulation method improves outcomes versus BT alone.

Q: How were participants grouped and how were treatments delivered?

Women with idiopathic overactive bladder were randomized into three groups: BT only, MStim+BT, or TTNS+BT. MStim and TTNS were administered twice weekly for 30 minutes per session over 6 weeks, totaling 12 sessions.

Q: What outcomes were measured, and what did the results show by week 6?

The primary outcome was the positive response rate defined by ≥50% fewer incontinence episodes at 6 weeks using a 3-day bladder diary. Response was significantly higher in the MStim+BT and TTNS+BT groups than in BT alone, with no significant difference between the two stimulation groups.

Q: Which stimulation method showed stronger improvements for voiding frequency?

Voiding frequency improved significantly more in the TTNS+BT group than in both the BT-only and MStim+BT groups, with TTNS showing greater effectiveness in reducing voiding frequency.

Sep 28, 2026

Uploaded by Liam

International Urogynecology Journal (2025) presents a randomized controlled trial comparing magnetic stimulation (MStim) and transcutaneous tibial nerve stimulation (TTNS), each added to bladder training (BT), in women with idiopathic overactive bladder. Participants were assigned to BT alone, MStim+BT, or TTNS+BT; stimulation was delivered twice weekly over 6 weeks. The primary endpoint was response based on ≥50% fewer incontinence episodes at 6 weeks. Results showed higher response in both stimulation groups versus BT alone, with TTNS improving voiding frequency.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction and Hypothesis

Methods

Results

Conclusions

Study Design

Population and Sample

Inclusion criteria

Clinical trial registration

International Urogynecology Journal (2025) 36:2379–2388 [https://doi.org/10.1007/s00192-025-06215-w](https://doi.org/10.1007/s00192-025-06215-w) Comparison of Magnetic and Transcutaenous Tibial Nerve Stimulation Added to Bladder Training for Overactive Bladder: A Randomized Controlled Trial NecmettinYildiz1 · Saadet Nur Sena Oztekin1 · Yesim Akkoc2 Received: 11 February 2025 / Accepted: 5 June 2025 / Published online: 7 July 2025 © The Author(s) 2025 Abstract Introduction and Hypothesis This study aimed to compare the efficacy of magnetic stimulation (MStim) and transcutaneous tibial nerve stimulation (TTNS), both combined with bladder training (BT), in women with idiopathic overactive bladder (iOAB) . Methods Women with iOAB were randomized into three groups: group 1 received BT only; group 2 received MStim plus BT; and group 3 received TTNS plus BT. MStim and TTNS were administered twice weekly, 30 min per session, for a total of 12 sessions over 6 weeks. The primary outcome was the positive response rate, defined as ≥ 50% fewer incontinence episodes, measured via a 3-day bladder diary at 6 weeks. Seconder outcomes included incontinence severity (pad test), voiding frequency, incontinence episodes, nocturia, number of pads used, symptom severity (OAB-V8), QoL (IIQ-7) . Results According to the sample size calculation, 66 women were included in the study, with 22 assigned to each group. The three groups were comparable in terms of demographic and clinical characteristics. The positive response rate (primary outcome) was significantly higher in groups 2 and 3 compared to group 1 at week 6 (66.7% and 90.5% vs. 35.0%, p = 0.001), with no significant difference between groups 2 and 3 (p = 0.130). Both stimulation groups (each n = 21) demonstrated significant improvements in incontinence severity, incontinence episodes, number of pads used, symptom severity, QoL, and treatment satisfaction compared to the BT-only group (n = 20) (p < 0.0167) . No significant differences were found between group 2 and group 3 for these parameters. Voiding frequency significantly improved in group 3 (med 11 to 6) compared to group 1 (med 11 to 8) and group 2 (med 12 to 8) (p < 0.0167) . Conclusions Both MStim plus BT and TTNS plus BT are more effective than BT alone in women with iOAB. These two stimulation methods have similar clinical efficacy, with TTNS demonstrating greater effectiveness in reducing voiding frequency. Clinical trial registration This study was [registered with ClinicalTrials.gov](registered with ClinicalTrials.gov) number, NCT05387824 . Keywords Idiopathic overactive bladder · Bladder training · Magnetic stimulation · Transcutaneous tibial nerve stimulation Handling Editor: Rui Liang Editor in Chief: Maria A. Bortolini * Necmettin Yildiz [necmi74tr@hotmail.com](necmi74tr@hotmail.com) Saadet Nur Sena Oztekin [senaoztekin@gmail.com](senaoztekin@gmail.com) Yesim Akkoc [yesim.akkoc@gmail.com](yesim.akkoc@gmail.com) 1 Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey 2 Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ege University, İzmir, Turkey Introductıon Idiopathic overactive bladder (iOAB) is a common condition in women, characterized by urinary urgency, frequency, nocturia, and urgency urinary incontinence, without identifiable neurological or structural pathology [1] . First-line management of iOAB includes conservative therapies such as bladder training (BT) and pelvic floor muscle (PFM) exercises. When these are insufficient, second-line treatments such aspharmacotherapy (e.g., antimuscarinics, beta-3 agonists) and neuromodulation techniques are considered [2–4] . Among neuromodulation approaches, transcutaneous tibial nerve stimulation (TTNS) and magnetic stimulation (MStim) have gained attention due to their noninvasive nature and ease of application. TTNS has shown efficacy in alleviating iO

FAQs

What is the study’s main objective and hypothesis?

The study compares the efficacy of MStim and TTNS, both combined with bladder training (BT), for women with idiopathic overactive bladder. The hypothesis is that adding either stimulation method improves outcomes versus BT alone.

How were participants grouped and how were treatments delivered?

Women with idiopathic overactive bladder were randomized into three groups: BT only, MStim+BT, or TTNS+BT. MStim and TTNS were administered twice weekly for 30 minutes per session over 6 weeks, totaling 12 sessions.

What outcomes were measured, and what did the results show by week 6?

The primary outcome was the positive response rate defined by ≥50% fewer incontinence episodes at 6 weeks using a 3-day bladder diary. Response was significantly higher in the MStim+BT and TTNS+BT groups than in BT alone, with no significant difference between the two stimulation groups.

Which stimulation method showed stronger improvements for voiding frequency?

Voiding frequency improved significantly more in the TTNS+BT group than in both the BT-only and MStim+BT groups, with TTNS showing greater effectiveness in reducing voiding frequency.

Sep 28, 2026

Uploaded by Liam