Shocking the bladder: TENS vs PTNS for urgency

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Female Subjects ≥18 years of age * OAB, UUI or Mixed Urinary Incontinence with urgency predominant symptoms and more bother from UUI than stress urinary incontinence * Failed trial of conservative therapy (including bladder training, fluid modification, diet modification, caffeine restriction, or pelvic floor training) -Failed trial of at least one pharmacologic treatment (anticholinergics, β3- adrenoceptor agonist) either due to inability to take the medication, adverse reaction to medication, or no improvement on medication * Willing to complete study questionnaires * Willing to adhere to 12 office visits for PTNS over 3 months if randomized to that arm * No contraindication to undergoing PTNS or TENS therapy Exclusion Criteria: * Age \< 18 years * Presence of urinary fistula * Male genital anatomy * Undergoing evaluation or treatment of recurrent (2 or more infections in the last 6 months or 3 or more infections in the last 12 months) or current urinary tract infection * Current Bladder stones * Bladder cancer or suspected bladder cancer * Gross Hematuria * Pregnancy or planning to become pregnant during the study * Cognitive impairment * Central or peripheral neurologic disorders such as multiple sclerosis, Parkinson's disease, spina bifida, spinal cord lesions, etc. * Metal implants such as pacemaker, implantable defibrillator, or metal implants where PTNS or TENS device needs to be placed (ankle/leg) * Uncontrolled diabetes * Diabetes with peripheral nerve involvement * Current use of anticoagulants (excluding aspirin) * Current use of anticholinergics or use within the last 4 weeks * Current use of botox bladder injections or bladder botox injection within the last year (12 months) * Current use of sacral neuromodulation therapy or currently implanted sacral neuromodulation device or leads * Bladder outlet obstruction * Urinary retention or gastric retention * Painful Bladder Syndrome/Interstitial Cystitis * Unable to be contacted for follow up by telephone * Inability to speak/read/understand English or Spanish