(Poster 78) Lower Urinary Tract Symptoms in Patients Using TTNS for Six Months or Longer

Objectives: This is a retrospective cohort study comparing the efficacy of transcutaneous tibial nerve stimulation (TTNS) for overactive bladder (OAB). Lower urinary tract symptoms, specifically frequency, episodes of nocturia, and pads per day, were compared between participants using TTNS for less than 6 months and those that used it for greater than 6 months.

Methods: Female patients within Kaiser Permanente Southern California who were prescribed a transcutaneous electrical nerve stimulator (TENS) unit between May 2021- May 2022 and had documented nursing visits for TTNS teaching and follow-up were included (n= 324). A manual chart review was performed to stratify the cohort into two groups, based on usage for 6 months or less (n= 242) vs usage for 6 months or more (n = 82). Subjective patient reports of improvement or no improvement in OAB symptoms after initiating therapy as well as objective reports of urinary frequency, episodes of nocturia, and usage of pads per day were collected. Frequency of TTNS therapy per week was further included to assess patient adherence.

Results: When analyzing median values between the two groups, there were no statistically significant differences in objective symptoms such as urinary frequency (p= 0.54), episodes of nocturia (p= 0.30), and pads per day (p= 0.65). However, statistically significant (p = 0.0006) changes in subjective overall improvement of OAB symptoms were noted after using TTNS for 6 months or more.

Conclusions: Although we found no statistically significant differences in changes in urinary frequency, episodes of nocturia, and pads per day between the two groups, TTNS therapy showed a statistically significant improvement of patient-reported OAB symptoms when used for 6 months or greater. This provides valuable insight into how extended use of a convenient, affordable, and patient-led therapy, such as TTNS, can enhance the patient experience and improve OAB symptoms. In this paper, we provide initial data on an important noninvasive and affordable treatment modality. In our future work, we plan on expanding the cohort study to better capture potential changes in objective outcomes.