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Extended-course transcutaneous tibial nerve stimulation for pediatric overactive bladder: a 6-Month prospective
Fangzheng Cheng1, Jian Wang2, Dongming Wang1
1Jian Wang Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
World Journal of Urology
|March 4, 2026
Summary
Extending transcutaneous tibial nerve stimulation (TTNS) for pediatric overactive bladder (OAB) to 24 weeks improved symptoms and identified many late responders. Continued TTNS may benefit non-responders, warranting further study.
Area of Science:
- Urology
- Pediatric Urology
- Neuromodulation
Background:
- Pediatric overactive bladder (OAB) significantly impacts quality of life.
- Transcutaneous tibial nerve stimulation (TTNS) is a recognized treatment for OAB.
- Optimal duration of TTNS for pediatric OAB remains under investigation.
Purpose of the Study:
- To evaluate the added clinical benefit of extending TTNS treatment duration from 12 to 24 weeks in children with OAB.
- To identify and characterize patients who respond late to TTNS therapy.
Main Methods:
- A prospective, single-arm cohort study was conducted.
- Home-based TTNS was administered with assessments at baseline, 12, and 24 weeks.
- The primary outcome was the change in OAB Symptom Score (OABSS), with responders defined by a minimal clinically important difference (MCID) of ≥3 points.
Main Results:
- Extending TTNS to 24 weeks demonstrated a significant increase in the responder rate (paired risk difference of 0.175, p=0.000122).
- Over half (51.9%) of initial non-responders at 12 weeks became responders by 24 weeks.
- Mean OABSS improved from baseline at both 12 weeks (3.64±2.25) and 24 weeks (5.14±2.63).
Conclusions:
- Extending TTNS treatment to 24 weeks provides additional symptom improvement in pediatric OAB patients.
- A substantial proportion of patients exhibit late response to TTNS without losing initial gains.
- Continuing TTNS beyond 12 weeks is a potential strategy for early non-responders, requiring validation through randomized controlled trials.
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