Electrical stimulation for an overactive bladder (OAB) involves sending an electrical current to the nerves that play a role in bladder function. The goal of the treatment is to suppress bladder contractions that squeeze out urine.

The Food and Drug Administration (FDA) has approved an invasive type of electrical stimulation that requires surgery and a noninvasive type that does not require surgery. According to a 2022 research article, they are both effective and have few side effects.

Keep reading to learn more about electrical stimulation for an overactive bladder and the different types, as well as their effectiveness and safety.

A doctor applying a blue pad to a person's leg for electrical stimulation for an overactive bladder.Share on Pinterest
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OAB affects an estimated 33 million people in the United States. It causes symptoms such as:

  • a strong, sudden urge to urinate
  • frequent urination
  • waking up to urinate at night
  • incontinence, or leakage

Treatment of an overactive bladder involves lifestyle modifications and medications. When these are not effective, electrical stimulation is an option.

OAB occurs due to a muscle in the bladder contracting too much. This muscle, known as the detrusor, is responsible for squeezing out urine. Electrical stimulation intends to inhibit these contractions to decrease the number of times a person needs to urinate.

Electrical stimulation can be noninvasive or invasive. The noninvasive option entails passing an electric current through the bladder muscle via an anal or vaginal probe or through a needle that a doctor inserts into the tibial nerve. The tibial nerve is a branch of the sciatic nerve that runs from the area behind the knee to around the ankle.

The invasive option involves the surgical implantation of electrodes within the body that stimulate one of the sacral nerve roots, which lie in the lower back.

The FDA has approved two types of electrical stimulation for OAB: sacral neuromodulation (SN) and posterior tibial nerve stimulation (PTNS).

Transcutaneous electrical nerve stimulation (TENS) is a modification of electrical stimulation therapy. The FDA has not approved TENS for this condition, although some people still use it for this purpose.

SN

SN is an invasive form of electrical stimulation. It entails surgical placement of an electrical stimulator under the skin that sends pulses to one of the sacral nerve roots in the lower back. These nerves play a role in bladder function.

PTNS

PTNS involves the placement of a needle above the ankle to stimulate the tibial nerve, which influences bladder function. The needle attaches to a device outside the body that sends electrical pulses through the nerve.

PTNS takes place in a clinical setting and consists of 30-minute weekly sessions for 12 weeks. It can be either percutaneous, which means the needle passes through the skin, or transcutaneous, which is noninvasive and uses electrodes on the surface of the skin.

TENS

TENS involves a battery-powered device that sends electrical impulses through electrodes on the skin surface. The site of the electrodes may be the tibial nerve, but alternative sites include the vaginal, penile, sacral, or rectal areas.

TENS treatment for OAB is noninvasive and self-administered, meaning people can do it at home.

Research indicates that the two FDA-approved types of electrical stimulation are effective for OAB.

An older 2014 clinical trial compared the effectiveness of a combination of SN and the medication tolterodine (Detrol) with the effectiveness of the medication only. It involved 240 participants with OAB.

After 3 months, the participants who received the combination therapy showed more improvements than the medication-only group.

Older research from 2009 evaluated the effectiveness of PTNS among 220 participants with overactive bladder. After 12 weeks, 54.5% of those who received PTNS treatment reported moderate or marked improvements, compared to 20.9% of those who received a placebo treatment. The authors concluded that PTNS was effective.

A TENS machine may help with OAB symptoms, but research exploring its benefits has found inconsistent results.

A relatively small 2022 clinical trial compared the effectiveness of TENS with that of anticholinergic medications, which are a standard drug treatment for OAB.

After 3 months of TENS use, those who received the TENS treatment experienced a significant reduction in symptoms compared to those who received the medication.

However, a 2016 review of 22 previous studies expressed caution in drawing conclusions based on the current evidence. The authors noted that while preliminary data indicates TENS is effective and safe, the quality of the data is low.

More reliable data from well-designed clinical trials are necessary to understand the value TENS machines might have in OAB treatment.

Electrical stimulation appears to be safe, but it has some side effects.

SN

SN is safe, but sometimes, side effects can mean doctors need to remove the electrical stimulator.

Side effects include pain at the site, which occurs in 11.8% of people, and a shift in position of part of the apparatus, which occurs in 7.9% of people. An additional complication is the risk of infections.

PTNS

People who have PTNS usually tolerate it well. Compared to SA, PTNS has fewer side effects and is not as invasive. An older 2012 study states that side effects are temporary, mild, and uncommon, affecting around 1–2% of individuals. These include the following at the needle site:

  • tingling and mild pain
  • bruising
  • bleeding

TENS

For most people, TENS is safe with little to no side effects. Despite the general safety, there are reports of allergic skin reactions to the electrode pads. Hypoallergenic pads are available for those with this problem.

Other occasional complications include nausea and fainting. Individuals should not use a TENS machine if they:

Below are some questions that a person may wish to ask a doctor:

  • What is causing my OAB?
  • Will electrical nerve stimulation help me?
  • If so, which type is best?
  • What kind of results can I expect?
  • Should I try other treatment options before having electrical nerve stimulation?
  • What lifestyle changes may help my symptoms?

Electrical stimulation for an overactive bladder is a safe and effective way to reduce the muscle contractions that cause the condition. The two main types are SN and PTNS. The FDA has approved these, and research suggests that they are effective and safe.

TENS is a modified type of electrical stimulation. Research is too preliminary to determine the effectiveness of TENS for an overactive bladder. People with questions about this treatment and the available options can speak with a doctor.