Parasacral versus tibial transcutaneous electrical stimulation to treat urinary urgency in adult women: Randomized controlled clinical trial.

INTRODUCTION: Urinary urgency is a very strong urge to urinate that is difficult to postpone and control. One of the physiotherapeutic resources that can be used in the treatment of urinary urgency is electrical nerve stimulation. The objective of this study is to investigate the effects of parasacral and tibial nerve transcutaneous electrical stimulation in improving urinary urgency in adult women. MATERIAL AND METHODS: Single-blinded randomized controlled clinical trial. PARTICIPANTS: Ninety-nine adult women with urgency. INTERVENTIONS: Transcutaneous electrostimulation for 12, 20-min sessions, twice a week. The tibial and parasacral groups received a current of F = 10 Hz and 200 µs pulse duration, while the sham group received a current of F = 100 Hz and 100 µs pulse duration, the active electrode placed over the scapula. Primary and secondary outcome measures: The primary outcome measure was urinary urgency, measured by the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and Overactive Bladder questionnaire-Validated 8-Question Awareness Tool (OAB-V8). Secondary outcomes were quality of life with the King's Health Questionnaire (KHQ) and voiding habits with the 24-h voiding diary. Assessments occurred pretreatment, after the sixth and 12th post-treatment sessions and at the 30-day follow-up. RESULTS: Both parasacral and tibial groups in the post-treatment presented fewer episodes of urgency than the sham group. The parasacral group showed better results than the sham group post-treatment for ICIQ-OAB scores, and in KHQ domains Impact of Incontinence and task limitations. Parasacral group participants had OAB-V8 score lower than 8 in the post-treatment and follow-up. CONCLUSION: Both tibial and parasacral groups had a positive and similar effect on reducing urinary urgency in adult women. Relative to the quality of life, transcutaneous parasacral electrostimulation was superior to transcutaneous tibial electrostimulation. CLINICAL TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC), http://ensaiosclinicos.gov.br, protocol RBR-9rf33n.