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Impact of Transcutaneous Electrical Nerve Stimulation on the Autonomic Nervous System in the Treatment of Overactive Bladder (StimHAV)

tiistai 18. elokuuta 2026 päivittänyt: Centre Hospitalier de Roubaix

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.

Tutkimuksen yleiskatsaus

Tila

Ei vielä rekrytointia

Yksityiskohtainen kuvaus

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:

  1. To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
  2. To assess the clinical effectiveness of transcutaneous electrical stimulation in patients with overactive bladder.
  3. To assess the clinical effectiveness of transcutaneous electrical stimulation on associated pelvic floor dysfunctions, including anal incontinence, constipation, and genitosexual disorders.
  4. 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.

Opintotyyppi

Interventio

Ilmoittautuminen (Arvioitu)

70

Vaihe

  • Ei sovellettavissa

Yhteystiedot ja paikat

Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.

Opiskeluyhteys

Tutki yhteystietojen varmuuskopiointi

Osallistumiskriteerit

Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.

Kelpoisuusvaatimukset

Opintokelpoiset iät

  • Aikuinen
  • Vanhempi Aikuinen

Hyväksyy terveitä vapaaehtoisia

Ei

Kuvaus

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.

Opintosuunnitelma

Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.

Miten tutkimus on suunniteltu?

Suunnittelun yksityiskohdat

  • Ensisijainen käyttötarkoitus: Tukevaa hoitoa
  • Jako: Ei käytössä
  • Inventiomalli: Yksittäinen ryhmätehtävä
  • Naamiointi: Ei mitään (avoin tarra)

Aseet ja interventiot

Osallistujaryhmä / Arm
Interventio / Hoito
Kokeellinen: Women with overactive bladder who have been prescribed transcutaneous electrical stimulation

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.

These interventions are performed specifically as part of the study and are not part of routine care.

Muut nimet:
  • Questionnaires completion
  • visits in hospital

Mitä tutkimuksessa mitataan?

Ensisijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
Heart rate variability
Aikaikkuna: 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

Toissijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Aikaikkuna: 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:

  • 1 resting phase
  • 2 active stimulation
  • 3 post-stimulation resting phase
Baseline and Week 12
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Aikaikkuna: 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:

  • 1 resting phase
  • 2 active stimulation
  • 3 post-stimulation resting phase
Baseline and Week 12
To assess the impact of transcutaneous electrical stimulation on autonomic nervous system function in patients with overactive bladder.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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.
Aikaikkuna: 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

Yhteistyökumppanit ja tutkijat

Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.

Tutkijat

  • Päätutkija: Guillaume Carnaux, physiotherapist specialized in, Centre Hospitalier Roubaix

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