Overactive Bladder Syndrome (OBS) is a common condition that impacts lifestyle, affects individuals of all ages, and results in a decline in quality of life. The diagnosis of OBS is clinical, characterized by symptoms such as urgency, increased daytime frequency, and/or nocturia, with or without urinary incontinence, in the absence of urinary tract infections or other diagnosed conditions. In clinical practice, only the parasacral and tibial nerves have been used to inhibit detrusor muscle hyperactivity, proving to be an effective and conservative approach for treating the symptoms of an overactive bladder. Conservative treatments for OBS include behavioral therapy (BT), bladder training (BT) combined with transcutaneous tibial nerve stimulation (TTNS), parasacral nerve stimulation (PNS), or medial plantar nerve stimulation (T-MPNS). These treatments are both cost-effective and less invasive.

The goal of this study was to evaluate the effects of BT with BT combined with TTNS, BT with BT combined with PNS, and BT with BT combined with T-MPNS on the quality of life in women with OBS.

This was a controlled and randomized clinical trial with three experimental groups: GE1: BT with BT combined with PNS; GE2: BT with BT combined with T-MPNS; and the control group (CG): BT with BT combined with TTNS. Inclusion criteria required women who had symptoms of OBS according to the OAB-V8 (Overactive Bladder Validated 8) questionnaire and who were over 18 years old. Evaluations were conducted before treatment, after treatment, and at a 30-day follow-up using the OAB-V8 (for overactive bladder symptoms) and KHQ (King's Health Questionnaire) for quality of life. Both transcutaneous electrostimulation methods used an asymmetric biphasic pulsed current with constant voltage, 12 sessions, twice a week, lasting 20 minutes at the participant's maximum intensity, with a frequency of 10Hz and a pulse duration of 200µs. To verify the normality of the data, the Shapiro-Wilk test was applied, and repeated measures ANOVA was used for analysis.

The sample ages were as follows: GE1 (40.57 ± 15.00); GE2 (42.12 ± 11.54); and CG (46.09 ± 17.03). Significant intra-group differences were observed after the interventions in the following KHQ domains: impact of urinary incontinence (p = 0.004); limitations in daily life activities (p < 0.001); physical limitations (p = 0.003); social limitations (p = 0.012); emotions (p = 0.018); sleep and well-being (p < 0.001); severity measures (p = 0.002); symptom scale (p < 0.001); and OBS symptoms (p < 0.001). No significant inter-group differences were observed, nor at follow-up.

Both groups showed significant improvement in the quality of life and in OBS symptoms after the interventions. This suggests that physical therapists should be particularly attentive to OBS symptoms, given their significant negative impact on quality of life.

Our study demonstrates that three effective transcutaneous electrostimulation options exist for inhibiting detrusor muscle hyperactivity, which can subsequently improve the quality of life for women with OBS.