Clinical Outcomes of Transcutaneous Tibial Nerve Stimulation: Face-to-Face Versus Telehealth Tuition

Transcutaneous tibial nerve stimulation (TTNS) is used to treat overactive bladder (OAB) syndrome. We hypothesized that TTNS instruction delivered via telehealth (TH) would be as effective as face-to-face (FtF) instruction in improving OAB symptoms.

In this prospective cohort study, 99 women with OAB self-selected FtF (n = 79) or TH (n = 20) instruction for TTNS setup. Groups received standardized education on device placement and usage. Primary outcome was the between-group comparison of change in International Consultation on Incontinence Questionnaire (ICIQ-SF) scores at 3 and 12 months. Secondary outcomes included between-group comparisons of Patient Global Impression of Improvement (PGI-I) score at 3 months and treatment persistence at 12 months. Between-group differences were analyzed using Student's t tests.

At 3 months, FtF and TH groups showed mean ICIQ-SF score reductions of 2.3 ± 1.8 and 1.9 ± 1.6 points respectively (between-group difference 0.4 points; 95% CI -1.79, 2.59; p = 0.60). PGI-I scores indicated improvement in 48.1% of FtF and 50.0% of TH participants. At 12 months, treatment persistence was 60.8% for FtF and 55.0% for TH groups. Among continued treatment responders, sustained improvement was observed, with mean ICIQ-SF reductions of 3.6 ± 2.4 points (FtF) and 4.0 ± 2.6 points (TH) from baseline (p = 0.48). Progression to third-line therapies was comparable between groups (FtF 24.0%, TH 25.0%).

Telehealth shows promise as an effective method for initiating TTNS treatment for OAB, providing comparable outcomes with FtF instruction. The approximate 50% response rate and sustained benefits among responders support TTNS as a viable treatment. Findings support broader implementation of TH TTNS instruction, potentially improving treatment access for suitable patients.