Transcutaneous Tibial Nerve Stimulation in Patients With Neurogenic Overactive Bladder After Stroke

Efficacy of Transcutaneous Tibial Nerve Stimulation in Patients With Neurogenic Overactive Bladder After Stroke: A Randomized Placebo-controlled Clinical Trial.

The investigators conducted a prospective, randomized, double-blind, placebo-controlled study based on the placebo technique to evaluate the efficacy of TTNS versus placebo in patients with OAB after stroke.

The main questions aimed to be answered are:

What are the effects of Trans Tibial Nerve Stimulation (TTNS) on incontinence-related clinical parameters and quality of life in patients with overactive bladder (OAB) after stroke compared to the placebo group? Participants (n:22) with post-stroke AAM who meet the exclusion and inclusion criteria will be divided into 2 groups using a randomization table. The first group will receive TTNS (n:11) and the second group will receive placebo TTNS (n:11). Measurements will be performed twice in total, before treatment and at the end of treatment (4th week).

Inclusion Criteria:

• Patients aged 40 and above with stable ischemic or hemorrhagic stroke.
• Patients with neurogenic detrusor overactivity symptoms accompanied by urinary incontinence complaints and a urinary frequency of 9 or more.
• Patients diagnosed with detrusor overactivity on urodynamic evaluation.
• Patients with hemiplegia lasting between 30 days and 1 year.
• Ability to understand procedures, benefits, and potential side effects.
• Patients scoring 22 or above on the Mini Mental Test.

Exclusion Criteria:

• Patients with post-stroke neurogenic detrusor overactivity receiving or previously received pharmacological treatment.
• Patients using intermittent catheterization or permanent catheterization as a bladder emptying method.
• Patients with a history of urinary incontinence and/or urinary retention before stroke.
• History of past urogynecological surgery.
• Presence of urinary tract infection, bladder tumor, or cardiac pacemaker.
• Significant fluid infusion requirement affecting urination or use of medication affecting bladder function.
• Patients who have received botulinum toxin injection for post-stroke neurogenic detrusor overactivity.
• Patients with postvoid residual volume above 150 mL.