Impact of Transcutaneous Electrical Nerve Stimulation on the Autonomic Nervous System in the Treatment of Overactive Bladder (StimHAV)
Impact of Transcutaneous Electrical Nerve Stimulation on the Autonomic Nervous System in the Treatment of Overactive Bladder: A Prospective, Single-Center Study (StimHAV)
The goal of this observational study is to evaluate the impact of Transcutaneous Electrical Nerve Stimulation on the autonomic nervous system in adults women with overactive bladder.
The main question it aims to answer is :
Does Transcutaneous Electrical Nerve Stimulation to treat overactive bladder have an impact on the autonomic nervous system ?
To answer this question, the primary outcome measure will be heart rate variability (HRV) during transcutaneous electrical nerve stimulation therapy
Participants will:
- Receive their first and last sessions of transcutaneous electrical nerve stimulation in the hospital.
- Complete questionnaires during their first and last transcutaneous electrical nerve stimulation sessions.
- Have their heart rate variability measured during their first and last transcutaneous electrical nerve stimulation sessions.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Rationale :
Overactive bladder (OAB) is a common condition that can have a major impact on quality of life. Transcutaneous peripheral electrical stimulation therapies are a recognized treatment option, but their mechanisms of action are still not fully understood.
Recent data suggest that their effectiveness may be related to changes in the autonomic nervous system. However, no study has yet evaluated this effect in patients with non-neurogenic overactive bladder. This study aims to better understand the physiological mechanisms involved, improve knowledge about these treatments, and contribute to their better use in clinical practice.
Objectives :
Primary objective:
The primary objective of this study is to evaluate the impact of transcutaneous electrical stimulation therapies on the overall balance of the autonomic nervous system in patients with overactive bladder.
Secondary objectives:
- To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
- To assess the clinical effectiveness of transcutaneous electrical stimulation in patients with overactive bladder.
- To assess the clinical effectiveness of transcutaneous electrical stimulation on associated pelvic floor dysfunctions, including anal incontinence, constipation, and genitosexual disorders.
- To assess the tolerability of transcutaneous electrical stimulation in patients with overactive bladder.
Study design :
This is a prospective, single-center, observational study conducted in routine clinical practice. It will include female patients with overactive bladder who are receiving transcutaneous peripheral electrical stimulation as part of their usual care.
Study procedure :
After confirmation of the diagnosis of overactive bladder by a specialist physician, patients will be prescribed transcutaneous peripheral electrical stimulation, transcutaneous tibial nerve stimulation (TTNS) or interferential stimulation (IF). They will then be referred to the study investigator for an inclusion visit.
At the initial visit (Week 0), after checking the eligibility criteria and obtaining informed consent, participants will receive pelvic health education and their first electrical stimulation session. Heart rate variability will be recorded using an ECG Holter monitor. Clinical data and study questionnaires will also be collected.
Participants will receive two 72-hour bladder diaries. The first will be completed at the beginning of the study and the second before the final visit.
Treatment will continue for 12 weeks according to the prescribed method: TTNS will be performed at home, IF will be performed in a physiotherapy clinic. A follow-up telephone call will be made at 6 weeks (± 1 week) to assess treatment adherence.
At 12 weeks (± 1 week), participants will attend a final visit. This visit will include an electrical stimulation session with HRV measurement, completion of the follow-up questionnaires, and collection of the final bladder diary.
Data collected at baseline and at 12 weeks will be compared to assess the impact of electrical stimulation therapies on the autonomic nervous system and overactive bladder symptoms.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Camille Trouillet, Clinical research associate
- Phone Number: 00320993131
- Email: camille.trouillet@ch-roubaix.fr
Study Contact Backup
- Name: Maxence Mokeddem, Clinical research associate
- Phone Number: 00320993131
- Email: maxence.mokeddem@ch-roubaix.fr
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Female
- Adult patient aged 18 years or older
- Clinical diagnosis of overactive bladder made by a urologist or gynecologist with no identified cause
- Eligible for transcutaneous tibial nerve stimulation (TTNS) or interferential stimulation (IF) as part of the management of non-neurogenic overactive bladder
- Body mass index (BMI) ≤ 30 kg/m²
- Able to understand and complete the study questionnaires independently
- No objection to participating in the study.
Exclusion Criteria:
- Neurogenic overactive bladder.
- Local irritative factors, such as bladder stones, bladder tumors, or urinary tract infection.
- Previous treatment with transcutaneous tibial nerve stimulation (TTNS).
- Previous treatment with interferential stimulation (IF).
- Contraindications to electrical stimulation, including: cancer, Pacemaker, Pregnancy, Conductive prosthetic material in the area of stimulation, Heart disease, Epilepsy, Active phlebitis or thrombophlebitis, Skin lesions in the treatment area
- Use of anticholinergic medication during the previous three weeks
- Objection to participating in the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Women with overactive bladder who have been prescribed transcutaneous electrical stimulation
|
Participants will:
These interventions are performed specifically as part of the study and are not part of routine care.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Heart rate variability
Time Frame: Baseline and Week 12
|
The primary outcome measure is the change in SDNN (Standard Deviation of Normal-to-Normal intervals, expressed in ms), a time marker of heart rate variability , between the initial measurement session (Week 0) and the final measurement session (Week 12)
|
Baseline and Week 12
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Change in the low-frequency power (LF, 0.04-0.15 Hz) of heart rate variability between Week 0 and Week 12, assessed for each of the three evaluation phases:
|
Baseline and Week 12
|
|
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Change in the High-frequency power (HF, 0.15-0.40 Hz) of heart rate variability between Week 0 and Week 12, assessed for each of the three evaluation phases:
|
Baseline and Week 12
|
|
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Low Frequency /High Frequency ratio : is calculated by dividing the low-frequency power by the high-frequency power.
|
Baseline and Week 12
|
|
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Root Mean Square of Successive Difference (RMSSD) : it is calculated as the average of the time intervals between successive heartbeats.
It is expressed in milliseconds (ms).
|
Baseline and Week 12
|
|
To assess the clinical effectiveness of transcutaneous electrical stimulation in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Change in bladder diary parameters between Week 0 and Week 12.
The bladder diary is a detailed record completed by the patient, which serves to assess the patient's bladder function.
|
Baseline and Week 12
|
|
To assess the clinical effectiveness of transcutaneous electrical stimulation in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Change in the total score and subscale scores of the ICIQ-OAB (International Consultation on Incontinence Questionnaire - Overactive Bladder) self-administered questionnaire between Week 0 and Week 12.
The overall score ranges from 0 to 16, where higher values indicate increased symptom severity.
|
Baseline and Week 12
|
|
To assess the clinical effectiveness of transcutaneous electrical stimulation in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Change in the total score and subscale scores of the ICIQ-LUTSqol (International Consultation on Incontinence Questionnaire - Lower Urinary Tract Symptoms Quality of Life) self-administered questionnaire between Week 0 and Week 12. The overall score ranges from 19 to 76. A score of 19 indicates the absolute lowest possible impact. A score of 76 indicates the highest possible level of impact. |
Baseline and Week 12
|
|
To assess the clinical effectiveness of transcutaneous electrical stimulation on anal incontinence.
Time Frame: Baseline and Week 12
|
Change in the total score and subscale scores of the anal incontinence questionnaires (Jorge and Wexner) between Week 0 and Week 12. The overall score ranges from 0 to 20. Score of 0: represents perfect continence Score of 20: represents complete incontinence |
Baseline and Week 12
|
|
To assess the clinical effectiveness of transcutaneous electrical stimulation on constipation.
Time Frame: Baseline and Week 12
|
Change in the total score and subscale scores of the ODS (Obstructed Defecation Score) constipation questionnaire between Week 0 and Week 12. The overall score ranges from 0 to 20. Score of 0 : represents normal defecation Score of 20 : represents severe obstructed defecation |
Baseline and Week 12
|
|
To assess the clinical effectiveness of transcutaneous electrical genitosexual disorders.
Time Frame: Baseline and Week 12
|
Change in the total score and subscale scores of the FSFI (Female Sexual Function Index) self-administered questionnaire between Week 0 and Week 12. The overall score ranges from 2.0 to 36.0 Score of 2.0 : represents absence of sexual activity or the maximum possible degree of sexual difficulty and pain Score of 36.0 : represents perfect sexual function and total freedom from sexual pain or difficulties |
Baseline and Week 12
|
|
To assess the tolerability of transcutaneous electrical stimulation in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Assessment of treatment tolerability using a Likert scale at Week 0 and Week 12. The total score ranges from 1 to 5. A score of 1 represents the highest level of discomfort experienced by the patient. A score of 5 represents the highest level of comfort experienced by the patient. |
Baseline and Week 12
|
|
To assess the tolerability of transcutaneous electrical stimulation in patients with overactive bladder.
Time Frame: Baseline and Week 12
|
Pain assessment related to the treatment using a visual analog scale at Week 0 and Week 12. A score of 0 represents no pain experienced by the patient. A score of 10 represents the maximum level of pain experienced by the patient. |
Baseline and Week 12
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Guillaume Carnaux, physiotherapist specialized in, Centre Hospitalier Roubaix
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Male Urogenital Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Lower Urinary Tract Symptoms
- Urological Manifestations
- Urinary Bladder Diseases
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Urinary Bladder, Overactive
- Health Care Facilities Workforce and Services
- Health Facilities
- Hospitals
Other Study ID Numbers
Other Study ID Numbers
- 2025-002
- ID RCB 2026-A01741-50 (Other Identifier: ANSM)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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