Transvaginal Electrical Stimulation for Treatment of Overactive Bladder Without Incontinence: A Pilot Cross-Over...

Area of Science:

• Urology
• Gynecology
• Pelvic Health

Background:

• Overactive bladder dry (OAB-dry) symptoms of urgency and frequency without incontinence are common.
• Transvaginal electrical stimulation (TES) is established for OAB with incontinence (OAB-wet) but not studied for OAB-dry.
• This study investigates TES for OAB-dry symptom management.

Purpose of the Study:

• To evaluate the efficacy of an at-home transvaginal electrical stimulation (TES) program for urgency and frequency symptoms in women with OAB-dry.
• To determine if TES can improve patient-reported outcomes and reduce voiding frequency in this population.

Main Methods:

• Prospective, randomized, cross-over, controlled trial involving women diagnosed with OAB-dry.
• Participants received 4 weeks of sham stimulation followed by 4 weeks of active TES, with a 3-week washout period in between.
• Outcomes measured included standardized questionnaires (OAB-q), voiding diaries, and pelvic floor muscle assessment.

Main Results:

• A statistically significant improvement in OAB-q scores was observed post-TES compared to baseline and sham treatment (p=0.007).
• A significant reduction in voids per 24 hours was noted after TES treatment (p=0.048).
• Positive treatment response, defined as intent to continue therapy, was associated with the absence of pelvic floor tenderness at baseline.

Conclusions:

• Transvaginal electrical stimulation (TES) is a viable and effective treatment for OAB-dry, significantly improving urinary urgency and frequency symptoms.
• The study suggests two phenotypes within OAB-dry: those with pelvic floor myofascial dysfunction who may not respond, and others who benefit from bladder-directive therapy.
• TES offers clinically meaningful improvements in patient-reported disease severity for suitable OAB-dry patients.