Efficacy and Safety of Intravesical Electrical Stimulation for Underactive Bladder: A Meta-Analysis and Systematic Review.

BACKGROUND

Underactive bladder (UAB) can lead to urinary retention and kidney damage, severely affecting patients' health. Currently, there are insufficient effective treatments. Some studies suggest that intravesical electrical stimulation (IVES) may relieve symptoms in patients with UAB, but its efficacy remains uncertain. This study aims to explore the effectiveness of IVES and provide guidance for clinical decision-making.

MATERIALS AND

METHODS

On the basis of the search keywords, we searched PubMed, Web of Science, Cochrane Library, and Embase data bases up to January 20, 2025 and screened studies according to the inclusion and exclusion criteria. We extracted urodynamic and symptom assessment indicators from eligible studies, calculated pooled mean differences (MDs) and 95% CIs, and validated results using subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and Egger's test.

RESULTS

Six studies with 310 patients were included. The pooled results showed postvoid residual urine volume (PVR) had a significant improvement (MD = -108.7 mL, 95% CI: -177.69; -39.71). The secondary outcomes, including voided volume, urine flow rate, voiding efficiency, and 24-hour clean intermittent catheterization first sensation capacity, were assessed. Among these, both voided volume (MD = 86.66 mL, 95% CI: 1.56; 171.77) and voiding efficiency (MD = 30.72%, 95% CI: 21.95; 39.49) showed improvement in patients who received IVES compared with those who did not. The most common adverse event was urinary tract infection, with no severe adverse events reported.

CONCLUSIONS

IVES might be effective in reducing PVR, increasing voided volume, and improving voiding efficiency in patients with UAB, and is a safe, minimally invasive, and simple treatment option. It can be considered as a treatment choice for UAB, although this conclusion still needs to be verified by large-scale and high-quality clinical studies. INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTERED ID: CRD420251011794.