Extended-course transcutaneous tibial nerve stimulation for pediatric overactive bladder: a 6-Month prospective...

To estimate the added clinical benefit of extending transcutaneous tibial nerve stimulation (TTNS) from 12 to 24 weeks in pediatric overactive bladder (OAB), and to characterize late responders.

Prospective single-arm cohort with home-based TTNS and assessments at baseline, 12, and 24 weeks. The primary outcome was change in OAB Symptom Score (OABSS) and responder status defined by a minimal clinically important difference (MCID) of≥3 points. Paired responder transitions were tested with McNemar's exact test and summarized as paired risk difference (RD) with 10,000-sample bootstrap 95% CIs; repeated-measures GEE/LMM were pre-specified for confirmatory modeling.

Among 80 paired observations, 12→24-week transitions were 0→0: 13, 0→1: 14, 1→0: 0, 1→1: 53. The paired RD in responder rate (24w-12w) was 0.175 (95% CI 0.100-0.263; McNemar p=0.000122). Late response occurred in 14 of 27 (51.9%) 12-week nonresponders. Mean OABSS improved by 3.64±2.25 at 12 weeks and 5.14±2.63 at 24 weeks.

Extending TTNS to 24 weeks was associated with additional symptom improvement and a substantial proportion of late responders without loss of response. Findings suggest that continuing TTNS beyond 12 weeks may be considered for early nonresponders, pending confirmation in randomized, sham-controlled trials.