Efficacy of the combination of transcutaneous tibial nerve stimulation(TTNS) and mirabegron in women with overactive bladder: a prospective randomized controlled trial

Objective: The management of overactive bladder (OAB) in women encompasses a range of strategies, from behavioral modifications to pharmacotherapy and nerve stimulation techniques. This prospective, randomized, controlled trial evaluates the efficacy of the combination of TTNS and mirabegron in symptom improvement over three months in women diagnosed with OAB. Patients and Methods: The study was designed as a randomized controlled trial. A total of 40 patients were prospectively randomized into two groups. Twenty patients in the combination group accepted TTNS and mirabegron therapy, and the other 20 patients as control only accepted mirabegron therapy. Primary outcomes were changes from baseline in the lower urinary tract symptoms. The severity of symptoms and quality of life (QoL) were assessed using the validated OAB questionnaire (OAB-q). Results: TTNS reduced the clinical symptoms of OAB, and the difference was statistically significant at all study sites (p<0.05). Regarding secondary outcomes, the OAB-q symptom bother score was lower in the combination group than in the mirabegron group (p<0.05). The OAB-q score in the combination group was statistically superior to that in the mirabegron group (p<0.05). The incidence of complications was not statistically significant between the two groups. Conclusion: The combination of TTNS and mirabegron represents a promising therapeutic strategy for women with overactive bladder, significantly improving symptoms and quality of life with a favorable safety profile. Further research with a larger sample size and long-term follow-up is warranted to confirm these findings and explore the underlying mechanisms of this combination therapy’s efficacy.