{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:12:21Z","timestamp":1787008341974,"version":"build-2736575974"},"reference-count":79,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Legal and General Group"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Overactive Bladder Syndrome (OAB) is common and distressing for older people. Transcutaneous Tibial Nerve Stimulation (TTNS) is a potential treatment when others have failed. Different electrical parameters\u2014electrical frequency, intensity, pulse width\u2014are used. We investigated their effect on urinary incontinence, urgency, frequency and nocturia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched MEDLINE, EMBASE and AMED to March 2025 for studies comparing TTNS to control\/sham in adults with OAB in clinical\/home settings. Two reviewers independently screened papers, extracted data and assessed risk of bias (using RoB2). We summarised studies narratively and used the GRADE framework. We meta-analysed RCTs (random-effects), grouping by electrical parameters. PROSPERO registration CRD42024490465.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 42 papers (13 RCTs), involving 2715 participants (972 in RCTs). Nearly half studies (47.6%) included people aged &amp;gt;\u2009=\u200960. TTNS protocols varied: electrical frequency 10\/20\u00a0Hz; intensity set with sensory or motor threshold; pulse width mostly 200 microseconds. No serious adverse effects were reported, only mild pain\/discomfort. TTNS at 10\u00a0Hz improved incontinence episodes (MD\u2009=\u2009\u20131.24, 95%CI \u20132.09 to \u22120.39, n\u2009=\u2009255, N\u2009=\u20093). TTNS with motor threshold improved urgency (MD\u2009=\u2009\u20131.44, 95%CI \u20132.69 to \u22120.19, n\u2009=\u2009193, N\u2009=\u20094) and nocturia (MD\u2009=\u2009\u20131.14, 95%CI \u20131.93 to \u22120.34, n\u2009=\u2009153, N\u2009=\u20093). Risk of bias was low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TTNS is a safe option to treat OAB. Electrical parameters may impact effectiveness (in favour of 10\u00a0Hz, motor threshold). Certainty is reduced due to the small number of studies and participants. Future studies should include different electrical parameters to clarify their impact, particularly with older people and to allow standardisation of future treatment and effect on specific symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afaf203","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T07:22:16Z","timestamp":1751872936000},"source":"Crossref","is-referenced-by-count":6,"title":["The importance of electrical parameters on transcutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"54","author":[{"given":"David Alejandro","family":"Vaca-Benavides","sequence":"first","affiliation":[{"name":"Advanced Care Research Centre, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics , Edinburgh, Scotland ,","place":["UK"]},{"name":"Institute for Integrated Micro and Nano Systems, The University of Edinburgh School of Engineering , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Ju","sequence":"additional","affiliation":[{"name":"Institute for Integrated Micro and Nano Systems, The University of Edinburgh School of Engineering , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Urology, Western General Hospital , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Aitken","sequence":"additional","affiliation":[{"name":"Department of Medicine of the Elderly, Royal Infirmary of Edinburgh , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil Kumar","family":"Appukuttan Nair Syamala Amma","sequence":"additional","affiliation":[{"name":"Advanced Care Research Centre, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics , Edinburgh, Scotland ,","place":["UK"]},{"name":"Institute for Integrated Micro and Nano Systems, The University of Edinburgh School of Engineering , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinjoy","family":"Mitra","sequence":"additional","affiliation":[{"name":"Advanced Care Research Centre, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics , Edinburgh, Scotland ,","place":["UK"]},{"name":"Institute for Integrated Micro and Nano Systems, The University of Edinburgh School of Engineering , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7375-4776","authenticated-orcid":false,"given":"Susan D","family":"Shenkin","sequence":"additional","affiliation":[{"name":"Advanced Care Research Centre, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics , Edinburgh, Scotland ,","place":["UK"]},{"name":"Institute for Integrated Micro and Nano Systems, The University of Edinburgh School of Engineering , Edinburgh, Scotland ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"2025072510214829800_ref1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0090-4295(02)02243-4","article-title":"The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the international continence society","volume":"61","author":"Abrams","year":"2003","journal-title":"Urology"},{"key":"2025072510214829800_ref2","author":"International Continence Society Overactive Bladder"},{"key":"2025072510214829800_ref3","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.urology.2009.07.1325","article-title":"Impact on quality of life of urinary incontinence and overactive bladder: a systematic literature review","volume":"75","author":"Bartoli","year":"2010","journal-title":"Urology"},{"key":"2025072510214829800_ref4","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s40266-020-00777-8","article-title":"Overactive bladder in frail older adults","volume":"37","author":"Shaw","year":"2020","journal-title":"Drugs Aging"},{"key":"2025072510214829800_ref5","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1046\/j.1464-410x.2001.02228.x","article-title":"How widespread are the symptoms of an overactive bladder and how are they managed? 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