Neuromodulation with microcurrents versus posterior tibial nerve stimulation in the treatment of overactive bladder: a prospective comparative study

Miguel Arrabal-Martin^1,2, Maria Isabel Martinez-Sanchez¹, Laura Jerez-Fernandez¹, Marta Sacristan-Ruiz¹, Maria Jose Garcia-Ortega¹, Andrea Maria Hernandez-Perez³, Miguel Angel Arrabal-Polo^1,2,*, Alberto Zambudio-Munuera¹, Mercedes Nogueras-Ocaña¹
1 Department of Urology, San Cecilio University Clinical Hospital, Granada, Spain
2 Biomedical Research Institute IBS Granada, University of Granada, Granada, Spain
3 Faculty of Health Sciences, University of La Laguna, Tenerife, Spain
* Corresponding Author: Miguel Angel Arrabal-Polo. Email: email
(This article belongs to the Special Issue: Advances and Evolving Techniques in Functional Urology)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.076194

Received 16 November 2025; Accepted 02 March 2026; Published online 15 May 2026

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Abstract

Background: Posterior tibial nerve stimulation (PTNS) using the Urgent PC device has been shown to improve symptoms of overactive bladder (OAB). In this context, non-invasive autonomic nervous system neuromodulation using microcurrents (NESA), delivered via the NXsignal device, has emerged as a potential alternative therapy. The study aimed to evaluate the initial efficacy of NESA in patients with an overactive bladder. Methods: We conducted a prospective, non-randomized study comparing microcurrent neuromodulation (NESA) with PTNS in 60 consecutively recruited patients, evaluating changes in clinical bladder diary parameters and urodynamic findings after 12 treatment sessions. The main variables measured were clinical (collected from a 3-day bladder diary), including: daytime urinary frequency (DUF); nocturnal urinary frequency (NUF); urgency episodes (EU); urgency urinary incontinence episodes (UUI) and urodynamic (first urge to void; maximum bladder capacity; urgency-related voiding; detrusor overactivity). Various parametric and non-parametric statistical tests were used, and statistical significance was considered at p < 0.05. Results: Favorable outcomes were observed across all clinical and urodynamic variables with both treatments (NESA vs. PTNS). A significant reduction in urgency episodes (EU) was observed in patients treated with PTNS (p = 0.006), while a significant reduction in detrusor overactivity was found in patients treated with NESA (p = 0.008). In the NESA group, the bladder tolerated a greater urine volume before the first desire to void, whereas significant differences in increased bladder capacity were observed in patients treated with PTNS. No adverse effects were detected in either treatment group. Conclusion: Both treatments were effective, with no statistically significant differences between NESA and PTNS in the management of OAB. Further studies are warranted to investigate the long-term effects of microcurrent neuromodulation, as well as to better define its optimal, patient-specific application.