Use of Transcutaneous Electrical Nerve Stimulation in the Management of Bladder Pain Syndrome: 2017 Update

  • Kenneth M. PetersEmail author


It is very interesting to look back to 1988 and realize how little was known regarding electrical stimulation or neuromodulation in the management of voiding dysfunction and pelvic pain. The original chapter had sparse data on the use of transcutaneous electrical nerve stimulation (TENS) as a means to improve symptoms of interstitial cystitis. It was suggested that other sites of stimulation such as intravaginal or posterior tibial nerve may improve clinical outcomes. The author commented that the ideal site of stimulation was unknown and research was needed to identify the best stimulation parameters to achieve good clinical outcomes. Since that time, cutaneous stimulation is routinely used, but still with little evidence. It is often physical therapists who use TENS and inferential stimulation units as a multimodal approach to managing chronic pelvic pain. There has been broadened interest in the impact of the pelvic floor and neuromuscular dysfunction as an underlying trigger for pain associated with interstitial cystitis. Thus, neuromodulation is a reasonable modality to offer patients with interstitial cystitis symptoms.


  1. 1.
    Marinkovic SP, Gillen LM, Marinkovic CM. Minimum 6-year outcomes for interstitial cystitis treated with sacral neuromodulation. Int Urogynecol J. 2011;22(4):407-412.Google Scholar
  2. 2.
    Peters KM, Feber KM, Bennett RC. A prospective single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis. BJU Int. 2007;100(4):835–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Tai C, et al. Differential role of opioid receptors in tibial nerve inhibition of nociceptive and nonnociceptive bladder reflexes in cats. Am J Physiol Renal Physiol. 2012;302(9):F1090–7.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Peters KM, Carrico DJ, Perez-Marrero RA, Khan AU, Wooldridge LS, Davis GL, MacDiarmid SA. Randomized trial of percutaneous tibial nerve stimulation versus sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol. 2010;183(4):1438–43.CrossRefPubMedGoogle Scholar
  5. 5.
    Kabay S, et al. Efficiency of posterior tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain: a Sham-Controlled Comparative Study. Urol Int. 2009;83(1):33–8.CrossRefPubMedGoogle Scholar
  6. 6.
    van Balken MR, et al. Percutaneous tibial nerve stimulation as neuromodulative treatment of chronic pelvic pain. Eur Urol. 2003;43(2):158–63.CrossRefPubMedGoogle Scholar
  7. 7.
    Fitzgerald MP, Payne DK, Lukacz ES, Yang CC, Peters KM, Chai TC, et al. Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness. J Urol. 2012;187(6):2113–8.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Peters KM, Killinger KA, Jaeger C, Chen C. Pilot study exploring chronic pudendal neuromodulation as a treatment option for pain associated with pudendal neuralgia. Low Urin Tract Symptoms. 2015;7(3):138–42. doi: 10.1111/luts.12066.CrossRefPubMedGoogle Scholar
  9. 9.
    Liberman D, Singh R, Siegel SW. Neuromodulation for pelvic pain and sexual dysfunction. Curr Bladder Dysfunct Rep. 2016;11(2):187–93.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Beaumont Health-Royal OakRoyal OakUSA

Personalised recommendations