Feasibility of Telehealth‐Delivered Electrotherapy for Neurogenic Bladder Care in Aotearoa New Zealand

Introduction: Neurogenic lower urinary tract dysfunction (NLUTD) is a major complication of spinal cord injury (SCI), yet access to specialist bladder care remains limited in many regions of Aotearoa New Zealand. Transcutaneous electrostimulation of sacral dermatomes (TESD) is a non‐invasive neuromodulation approach that can be delivered remotely. Objectives: To assess the safety, feasibility and preliminary effectiveness of a telehealth‐delivered, self‐administered TESD protocol for people with chronic SCI. Methods: Fifteen adults with chronic SCI and NLUTD completed a 4‐week home‐based TESD programme using portable stimulation devices targeting the S3 dermatomes. Participants performed daily 15 min sessions under remote supervision. Primary outcomes were safety, feasibility and participant satisfaction; secondary outcomes included the Neurogenic Bladder Symptom Score (NBSS), urinary‐related quality of life (QoL), catheterisation frequency and maximal catheterisation volume. Results: All participants completed the study with full protocol adherence and no adverse events, confirming safety and operational feasibility. Participants reported high satisfaction and ease of self‐management. NBSS scores decreased significantly (−6.13; 95% CI −7.25 to −5.02; p < 0.001) and urinary‐related QoL improved (−0.87; 95% CI −1.20 to −0.53; p = 0.011). Four participants achieved partial recovery of spontaneous voiding with a reduction in catheterisation frequency. Conclusion: Telehealth‐delivered TESD is safe, feasible and practical, with early signals of clinical benefit. This decentralised model may improve access to bladder care for people with SCI and warrants evaluation in larger, controlled trials. Trial Registration: Australian New Zealand Clinical Trials Registry (06/07/2021, ACTRN12621000869875).