Effectiveness of transcutaneous tibial nerve stimulation on anticholinergic refractory neurogenic detrusor overactivity in individuals with suprasacral spinal cord injury: A urodynamic study
Journal of Spinal Cord Medicine, cilt.49, sa.5, ss.1109-1115, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 49 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/10790268.2025.2545064
- Dergi Adı: Journal of Spinal Cord Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.1109-1115
- Anahtar Kelimeler: Neurogenic bladder, Transcutaneous Tibial nerve stimulation, Spinal cord injury, Urodynamics, Detrusor overactivity
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Context: Individuals with suprasacral spinal cord injury (SCI) often face significant clinical and quality-of-life (QoL) burdens due to neurogenic detrusor overactivity (NDO). Transcutaneous tibial nerve stimulation (TTNS) is a non-invasive neuromodulation technique that may serve as a treatment option, but evidence regarding its effectiveness in anticholinergic-refractory NDO remains limited. Objectives: To evaluate the effectiveness of TTNS on urodynamic parameters in individuals with SCI who have anticholinergic-refractory NDO. Methods: Twenty-one patients with suprasacral SCI completed the study, of whom 42.9% had complete injuries. Twelve TTNS sessions (20 Hz, 200 ms, 30 minutes) were administered twice weekly. Urodynamic outcomes were assessed using reflex volume (RV), maximal cystometric capacity (MCC), maximal detrusor pressure (Pdet-max), and bladder compliance (BC). TTNS was considered positive if RV and/or MCC increased by ≥100 mL or ≥50% from baseline. The Neurogenic Bladder Symptom Score (NBSS) was used to assess symptom severity. Results: Significant improvements were observed in RV, MCC, Pdet-max, and BC after TTNS (P < 0.001). No statistically significant differences in urodynamic parameter changes following TTNS were observed between groups categorized by either injury severity or duration (P > 0.05). TTNS was considered positive in 9 patients (42.9%) based on RV and/or MCC improvements. Following TTNS, significant improvements were observed in the incontinence, storage and voiding, QoL subdomains of the NBSS (P < 0.05). Conclusion: Although Pdet-max remained >40 cmH2O in nearly half of the patients after TTNS, improvements in both urodynamic parameters and NBSS scores indicate that TTNS may provide clinical benefit in patients with anticholinergic-refractory NDO.