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Analgesia Using Transcutaneous Electric Nerve Stimulation in Office Bladder Chemodenervation, a Randomized Controlled
Diego Hernandez-Aranda1, Joseph Panza1, Marc Eigg2
1From the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Rochester School of Medicine and Dentistry.
Urogynecology (Philadelphia, Pa.)
|November 6, 2023
Summary
Transcutaneous electric nerve stimulation (TENS) significantly reduced pain during office bladder chemodenervation injections for overactive bladder. This safe, noninvasive method offers a new analgesic option for patients, improving satisfaction.
Area of Science:
- Urology
- Pain Management
- Neuromodulation
Background:
- Office bladder chemodenervation with onabotulinumtoxinA (BOTOX) is a standard treatment for overactive bladder and urge urinary incontinence.
- Transcutaneous electric nerve stimulation (TENS) has demonstrated analgesic effects in other gynecological procedures.
- The efficacy of TENS as an adjuvant analgesic for bladder chemodenervation has not been previously investigated.
Purpose of the Study:
- To evaluate the effectiveness of TENS in reducing pain during office-based bladder chemodenervation.
- To compare pain visual analog scale (VAS) scores between active TENS and placebo TENS groups.
- To assess patient satisfaction and adverse events associated with TENS use during the procedure.
Main Methods:
- A double-blind, randomized controlled trial was conducted with 101 participants undergoing office chemodenervation.
- Participants were randomized to receive either active TENS or placebo TENS during the onabotulinumtoxinA injections.
- Pain was measured using the VAS and a 5-point Likert scale, with satisfaction assessed on a 10-point scale.
Main Results:
- The active TENS group reported significantly lower pain VAS scores compared to the placebo group (mean difference >10 mm, P=0.01).
- Patient satisfaction scores were high in both groups, with no statistically significant difference between active and placebo TENS.
- No significant adverse events were reported, indicating TENS is a safe adjuvant therapy.
Conclusions:
- Transcutaneous electric nerve stimulation (TENS) is a safe, noninvasive, and effective adjuvant analgesic option for patients undergoing office bladder chemodenervation.
- The use of TENS can lead to a significant reduction in procedural pain.
- TENS offers a valuable additional pain management strategy for outpatient bladder chemodenervation procedures, enhancing patient comfort and satisfaction.
