A Garment-Integrated Sacral TENS System for Overactive Bladder in Older Adults: A Design Proposal and Narrative Evidence Synthesis

Overactive bladder (OAB) can substantially affect quality of life in older adults. This paper presents a garment-integrated transcutaneous electrical nerve stimulation (TENS) design concept: two 3 cm × 3 cm conductive-fabric electrodes integrated into stretchable shorts over the intended sacral stimulation region and connected by leads to a portable stimulator. The supporting evidence comes from separate published studies, not tests of this prototype. In a two-week randomised study involving 40 women, Sharma et al. (2016) reported within-group improvements in four Overactive Bladder Symptom Score (OABSS) domain scores, including daytime frequency (1.49 to 0.45) and nocturnal frequency (1.70 to 0.50); placebo participants also improved, so these p-values do not establish between-group effectiveness. In a crossover study of 10 healthy adults, Jafari et al. (2025) detected no statistically significant differences on several comfort and stimulation measures between lotion-hydrated textile and hydrogel electrodes during thigh neuromuscular electrical stimulation. Those electrodes were substantially larger and used at a different anatomical site and stimulation setting. No electrode impedance, clinical outcome, fit, electrical-output, safety or durability measurements were performed on the garment described here. Lotion application, anatomical alignment and repeated-use safety remain unresolved. The system should therefore be considered a prototype design requiring bench and prospective clinical validation, not a clinically demonstrated treatment.