Comparison of Transcutaneous Tibial Nerve Stimulation Protocols and Predictors of Success in Overactive Bladder

Objective: To evaluate whether different treatment schedules of transcutaneous tibial nerve stimulation (TTNS) influence clinical outcomes in women with overactive bladder (OAB) and to investigate factors associated with treatment response.Materials and Methods: A total of sixty women with OAB completed a course of 12 TTNS sessions. Patients received either two sessions per week for 6 weeks (Group 1, n=29) or three sessions per week for 4 weeks (Group 2, n=31). Symptom severity and treatment outcomes were assessed using the Overactive Bladder-Validated 8-question Screener (OAB-V8) and a 3-day bladder diary. Clinical response was determined according to predefined criteria for meaningful symptom improvement. Variables associated with treatment response were analyzed using logistic regression analysis.Results: Both treatment schedules resulted in comparable outcomes. Post-treatment OAB-V8 scores (16.5 ± 10.30 vs. 17.26 ± 9.87; p=0.609), bladder diary findings, and overall response rates were similar between groups. Treatment success was achieved in 75.8% of patients in Group 1 and 74.1% in Group 2 (p=0.881). Diabetes mellitus and the indication for treatment were associated with treatment outcome in univariate analyses. In multivariable analysis, previous discontinuation of anticholinergics or β3-adrenoceptor agonist therapy due to adverse effects or contraindications remained the only independent predictor of successful TTNS treatment.Conclusion: Comparable clinical improvements were observed in both groups, suggesting that increasing weekly treatment frequency does not improve outcomes. Approximately three out of four patients experienced meaningful symptom relief. Patients unable to continue pharmacological treatment due to intolerance/contraindications may represent a subgroup particularly likely to benefit from TTNS.