Intermittent urgency-activated, transcutaneous tibial nerve stimulation: Feasibility and urodynamic effects in overactive bladder

This short report extends our previous proof-of-concept on intermittent, urgency-activated transcutaneous tibial nerve stimulation (TTNS) during invasive cystometry. Twenty-one adults with overactive bladder and detrusor overactivity underwent consecutive baseline and urgency-activated TTNS cystometries, with stimulation manually triggered at each onset of urgency. Compared with baseline, TTNS increased maximum cystometric capacity by 79 mL and reduced maximum detrusor pressure by 26 cmH 2 O, with marked reductions in involuntary detrusor contractions and urgency urinary incontinence episodes. Overall, 85.7% of participants met predefined response criteria, including complete suppression of detrusor overactivity in 71.4% (Criterion A) and partial response in 14.3% (Criterion B). Exploratory clustering identified three response patterns: a robust global response (capacity and pressure), a moderate balanced response, and a pressure-dominant response with limited capacity change. These findings confirm feasibility but derive from a modest, single-arm physiological study; larger sham-controlled trials are required to validate these patterns and clarify clinical relevance.