Physiotherapeutic interventions for overactive bladder
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20263486Keywords:
Overactive bladder, Outcome measures, Urinary incontinence, Nocturia, Behavioral therapy, Biofeedback, Quality of lifeAbstract
Overactive bladder (OAB) is a common urinary disorder characterized by urgency, frequency, nocturia, and urge urinary incontinence (UUI), which can significantly impair quality of life (QoL). This study aimed to review the effectiveness of physiotherapeutic interventions in the management of OAB. Relevant studies published between 2013-2026 were collected from PubMed, Google Scholar, ResearchGate, and Cochrane Library. Outcome measures commonly used across the studies included OAB symptom score (OABSS), OAB questionnaire (OAB-q), international consultation on incontinence questionnaire OAB (ICIQ-OAB), dysfunctional voiding scoring system (DVSS), visual analogue scale (VAS), bladder diaries, uroflowmetry parameters, QoL questionnaires, pad tests, and frequency-volume charts. A total of 22 studies were included based on predefined eligibility criteria, including 10 studies on electrotherapeutic modalities, 5 studies on therapeutic exercises, and 7 studies examined the combined effects. Regarding the study population, 5 studies were conducted on children, 11 studies on women, and 6 studies included both men and women, while no study exclusively investigated only men. Findings demonstrated electrotherapeutic modalities such as transcutaneous tibial nerve stimulation (TTNS), transcutaneous electrical nerve stimulation (TENS), interferential current (IFC) and biofeedback significantly reduced urinary urgency, frequency, nocturia, and UUI while improving QoL. This study concludes that therapeutic exercises, including pelvic floor muscle training (PFMT), bladder training, urge suppression techniques and bladder training (BT), showed significant improvements in OAB symptoms and bladder control. Studies investigating combined interventions, particularly behavioral advice and PFMT (BA-PFMT), TTNS with behavioral therapy, and PFMT combined with tibial nerve stimulation, reported greater clinical benefits compared with single interventions. The existing studies indicate both electrotherapeutic modalities and therapeutic exercises are effective, safe, and non-invasive treatments for OAB. However, the combination of these approaches results in superior outcomes, leading to greater reductions in symptoms, enhanced bladder control and improved QoL.
References
Wang X, Li L, Zhang G, Zhu C, Min H, Zhu X, et al. Overactive bladder symptoms profile and related factors among women during the perinatal period: a latent profile analysis. BMC Pregnancy Childbirth. 2025;25(1):850.
Al Edwan G, Abdelazim MS, Salhab SE, Jamal YM, Soliman MA. The Prevalence of Overactive Bladder Symptoms in Women in Algeria, Egypt, Jordan and Lebanon: A Cross-Sectional Population-Based Survey. Adv Ther. 2021;38(2):1155-67.
Scarneciu I, Lupu S, Bratu OG, Teodorescu A, Maxim LS, Brinza A, et al. Overactive bladder: A review and update. Exp Ther Med. 2021;22(6):1444.
Koch M, Sayahpour H, Carlin GL, Dorittke T, Loimer R, Dibon A, et al. Characteristics of female overactive bladder syndrome: Results from a large retrospective cohort spanning 15 years. Maturitas. 2025;202:108736.
Hutchinson A, Nesbitt A, Joshi A, Clubb A, Perera M. Overactive bladder syndrome: Management and treatment options. Aust J Gen Pract. 2020;49(9):593-8.
Lee HE, Cho SY, Lee S, Kim M, Oh SJ. Short-term Effects of a Systematized Bladder Training Program for Idiopathic Overactive Bladder: A Prospective Study. Int Neurourol J. 2013;17(1):11-7.
Brubaker L. Urgency: the cornerstone symptom of overactive bladder. Urology. 2004;64(6):12-6.
Wallace KM, Drake MJ. Overactive bladder. F1000Research. 2015;4:1406.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61(1):37-49.
Barroso U Jr, Viterbo W, Bittencourt J, Farias T, Lordêlo P. Posterior tibial nerve stimulation vs parasacral transcutaneous neuromodulation for overactive bladder in children. J Urol. 2013;190(2):673-7.
de Paula LIDS, de Oliveira LF, Cruz BP, de Oliveira DM, Miranda LM, de Moraes Ribeiro M. Parasacral transcutaneous electrical neural stimulation (PTENS) once a week for the treatment of overactive bladder in children: A randomized controlled trial. J Pediatr Urol. 2017;13(3):263.e1-e6.
Rafaqat A, Sattar MI, Hafeez M, Shahzad MF. The effectiveness of interferential current on overactive bladder syndrome. J Nov Physiother. 2017;7(3):10-2.
Mallmann S, Ferla L, Rodrigues MP, Paiva LL, Sanches PRS, Ferreira CF, et al. Comparison of parasacral transcutaneous electrical stimulation and transcutaneous posterior tibial nerve stimulation in women with overactive bladder syndrome: A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2020;250:203-8.
Welk B, McKibbon M. A randomized, controlled trial of transcutaneous tibial nerve stimulation to treat overactive bladder and neurogenic bladder patients. Can Urol Assoc J. 2020;14(7):E297-303.
Pierre ML, Friso B, Casarotto RA, Haddad JM, Baracat EC, Ferreira EAG. Comparison of transcutaneous electrical tibial nerve stimulation for the treatment of overactive bladder: a multi-arm randomized controlled trial with blinded assessment. Clinics (Sao Paulo). 2021;76:e3039.
Cava R, Orlin Y. Home-based transcutaneous tibial nerve stimulation for overactive bladder syndrome: a randomized, controlled study. Int Urol Nephrol. 2022;54(8):1825-35.
Aydogmus H, Sengul M, Bolel O, Kotan TS. Effectiveness of transcutaneous tibial nerve stimulation on overactive bladder treatment. Pak J Med Sci. 2025;41(6):1629-37.
Rashid S, Sajid O. Effectiveness of Electric Muscle Stimulation (EMS) and Transcutaneous Electric Nerve Stimulation (TENS) in patients with overactive bladder: A randomized controlled trial. Pak J Med Sci. 2025;41(11):3259-64.
Veiga ML, Costa EV, Portella I, Nacif A, Martinelli Braga AA, Barroso U Jr. Parasacral transcutaneous electrical nerve stimulation for overactive bladder in constipated children: The role of constipation. J Pediatr Urol. 2016;12(6):396.e1-6.
Kulaksizoğlu H, Akand M, Çakmakçi E, Gül M, Seçkin B. Effectiveness of pelvic floor muscle training on symptoms and uroflowmetry parameters in female patients with overactive bladder. Turk J Med Sci. 2015;45(2):449-53.
Fitz F, Sartori M, Girão MJ, Castro R. Pelvic floor muscle training for overactive bladder symptoms - A prospective study. Rev Assoc Med Bras (1992). 2017;63(12):1032-8.
Pal M, Chowdhury RR, Bandyopadhyay S. Urge suppression and modified fluid consumption in the management of female overactive bladder symptoms. Urol Ann. 2021;13(3):263-7.
Burzynski B, Jurys T, Kwiatkowska K, Cempa K, Paradysz A. Physiotherapeutic assessment and management of overactive bladder syndrome: a case report. Physiother Theory Pract. 2023;39(3):650-7.
Voorham JC, De Wachter S, Van den Bos TWL, Putter H, Lycklama À Nijeholt GA, et al. The effect of EMG biofeedback assisted pelvic floor muscle therapy on symptoms of the overactive bladder syndrome in women: A randomized controlled trial. Neurourol Urodyn. 2017;36(7):1796-803.
Bykoviene L, Kubilius R, Aniuliene R, Bartuseviciene E, Bartusevicius A. Pelvic Floor Muscle Training With Or Without Tibial Nerve Stimulation and Lifestyle Changes Have Comparable Effects on The Overactive Bladder. A Randomized Clinical Trial. Urol J. 2018;15(4):186-92.
Rizvi RM, Chughtai NG, Kapadia N. Effects of Bladder Training and Pelvic Floor Muscle Training in Female Patients with Overactive Bladder Syndrome: A Randomized Controlled Trial. Urol Int. 2018;100(4):420-7.
Pekbay Y, Ergin O, Topuz B, Sarikaya S, Acar ZZ, Irkilata HC, et al. The effects of pelvic floor muscle therapy on symptoms, voiding, and pelvic floor muscle activity parameters in children with overactive bladder. Neurourol Urodyn. 2019;38(5):1430-42.
Paker MK, Yuvaci HU, Kiliç Y, Nas K, Bostanci MS, Cevrioğlu AS, et al. Comparison of the effectiveness of pelvic floor muscle training, biofeedback, and tibial nerve stimulation in overactive bladder syndrome: A prospective randomized controlled study. J Clin Obstet Gynecol. 2023;33(4):236-44.
D'Alessandro Barbosa MV, Matheus LBG, Garcia PA, Bradaschia JS, da Silva ML, Pereira ECL, et al. Randomized trial of transcutaneous tibial nerve stimulation to treat overactive bladder in older women. PLoS One. 2026;21(7):e0353194.
Matias MMP, Fitz FF, Gimenez MM, Ferreira LA, Bortolini MAT, Castro RA. Effects of behavioral treatment and pelvic floor muscle training on overactive bladder syndrome: a randomized control trial. Braz J Phys Ther. 2026;30(1):101541.
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Copyright (c) 2026 Dr. Shavez Mansoori, Ashudeep Kaur, Dr. Supreet Bindra, Dr. Pankajpreet Singh
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