Emerging Implantable Tibial Nerve Stimulation Devices for Overactive Bladder.

Abstract

Overactive bladder (OAB) substantially reduces quality of life (QoL), and novel implantable percutaneous tibial nerve stimulation (iPTNS) devices have emerged as promising alternatives to conventional management. This review provides a comprehensive comparative analysis of iPTNS devices for OAB, evaluating clinical outcomes, technical specifications, regulatory status, innovative features, and limitations-key aspects insufficiently addressed in prior studies. A narrative synthesis was conducted by reviewing clinical trials, technical reports, and regulatory documents related to 7 iPTNS devices. The analysis focused on improvements in health-related QoL (HRQoL), reductions in urgency urinary incontinence (UUI), device design variability, and regulatory distinctions. Our review revealed substantial differences among devices in terms of clinical efficacy (HRQoL and UUI reduction), technical design (including power sources and implantation methods), and regulatory status, with some devices approved by the U.S. Food and Drug Administration and others still under development. While iPTNS devices show considerable promise in OAB management, significant gaps remain regarding long-term outcomes and real-world adherence. Future innovations, particularly closed-loop neuromodulation, hold promise for improving efficacy and advancing personalized therapy.