Comparison of the Effectiveness of Pelvic Floor Muscle Training, Biofeedback, and Tibial Nerve Stimulation in Overactive Bladder Syndrome: A Prospective Randomized Controlled Study

Abstract

Objective: It was aimed to comparatively assess the effectiveness of pelvic floor muscle training (PFMT), biofeedback (BF), and transcutaneous tibial nerve stimulation (TTNS) treatments in overactive bladder (OAB) patients. Material and Methods: The patients presented to the urogynecology outpatient clinic between June 2017 and March 2018. They were randomly divided into Group 1: PFMT (n=31), Group 2: PFMT and BF (n=32), and Group 3: PFMT and TTNS (n=33). Patients who received anticholinergic therapy, those who had a previous incontinence surgery or had neurological diseases, those who were pregnant, those who were breastfeeding, those with abnormal liver-kidney functions, persistent urinary infection, or atrophic vaginitis, and those who did not agree to take part in the study were excluded. The OAB Questionnaire (OAB-V8), the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the Female Sexual Function Index forms were filled out before and after the 12-week treatment. Results: Daytime and nighttime urinary frequency, total urinary incontinence, and pad test values were lower after the treatment compared to before in all three groups (p<0.001). A statistically significant decline was seen in post-treatment ICIQSF and OAB-V8 scores compared to pre treatment scores in all three groups (p<0.01). The decrease in daytime urinary frequency was seen to be statistically significant in Group 2, and the values in this group were lower compared to those in Groups 1 and 3 (p: 0.045, p: 0.014, respectively). Conclusion: The overall effectiveness of the conservative treatments was determined to be similar. In the selection process, conservative treatment methods should be personalized.