Transcutaneous electrical nerve stimulation for pelvic pain: A scoping review of treatment protocols, practical indications, and caveats

Neurourol Urodyn. 2023 Mar;42(3):631-640. doi: 10.1002/nau.25137. Epub 2023 Jan 26.

Abstract

Background: Neuromodulation (NM) is a family of therapies based on electrical stimulation to target specific nerves that control LUTS (Lower Urinary Tract Symptoms) and pain. The aim is to modulate what is happening within the nervous system to achieve therapeutic effects. A particular type of neuromodulation, called TENS (Transcutaneous Electrical Nerve Stimulation), has proven effective for treating pelvic pain. The available evidence provides indications regarding the many aspects of TENS that influence therapeutic effects, but a comprehensive review has yet to be conducted.

Methods: Scoping review on Pubmed, CINAHL, Embase, Scopus, and Web of Science, including clinical trials, reviews, case studies or series, and other descriptive studies, according to the Joanna Briggs and PRISMA methodology.

Results: The 31 papers retrieved allowed the formulation of precise indications about the DOs and DON'Ts of electrode placement, waveform, pulse duration, pulse frequency, amplitude, session duration, and frequency of sessions. This paper also discusses the biochemical and neuro urological mechanisms of TENS.

Conclusion: TENS effectiveness is influenced by many factors, some self-evident, others subtle, which this paper elucidates. Pelvic pain requires a multimodal approach, of which TENS is just a part. TENS should therefore be viewed as one of the components of the rehabilitation program in the frame of thorough and continuous patient assessment.

Keywords: TENS; neuromodulation; pelvic pain; rehabilitation.

Publication types

  • Review

MeSH terms

  • Clinical Protocols
  • Electric Stimulation
  • Humans
  • Lower Urinary Tract Symptoms* / therapy
  • Pelvic Pain / therapy
  • Systematic Reviews as Topic
  • Transcutaneous Electric Nerve Stimulation* / methods