Non-invasive brain stimulation as a promising therapy for lower urinary tract symptoms: systematic review

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• Picked for Urology (top studies of the week, 30 August 2026): Systematic review of NIBS for LUTS

Abstract

PURPOSE: Lower urinary tract symptoms (LUTS) are prevalent in neurological conditions and can significantly reduce quality of life. Although various treatments are available, many patients remain unresponsive or face side effects. Noninvasive brain stimulation (NIBS), such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), modulates cortical excitability and may modulate the brain-bladder network that controls the micturition cycle. We performed a systematic review to assess the clinical effectiveness, underlying mechanisms, treatment protocols, and safety of NIBS for LUTS with the available evidence predominantly derived from neurogenic populations. METHODS: A systematic review without meta-analysis was conducted in accordance with the PRISMA 2020 statement. PubMed (MEDLINE), Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched through December 31, 2025. We included prospective and randomized clinical studies in English that assessed NIBS for adult LUTS. Data extracted included population details, stimulation types and protocols, clinical and urodynamic results, and any adverse events. RESULTS: Among 823 records identified, 11 studies met the eligibility criteria. NIBS enhanced objective urodynamic measures. For storage dysfunction, detrusor pressure decreased by 11.6 cmH2O, and bladder capacity increased by 60 to 120 mL. For voiding dysfunction, detrusor pressure rose by 10 to 20 cmH2O, maximal flow rate improved, and post-void residual volume decreased by 80 to 150 mL. Patient-reported outcomes consistently showed improvement. No serious adverse events were reported. CONCLUSION: NIBS appears to be a safe and promising therapeutic option for neurogenic LUTS, although the available evidence remains heterogeneous. Larger randomized trials are needed to determine optimal stimulation targets, treatment duration, and the role of NIBS within the therapeutic algorithm.

Abstract as published, via PubMed.