Objective: To verify whether the combination of transcutaneous electrical neural stimulation (TENS) with oxybutynin in the treatment of women with overactive bladder (OAB) would be more effective than isolated treatments. Methods: We randomized 75 women with OAB, in three groups: GI-30 min TENS, twice a week; GII-daily slow release 10 mg oxybutynin; and GIII-TENS + oxybutynin (multimodal); all for 12 weeks. Patients were evaluated with validated questionnaires International Consultation on Incontinence-Short Form (ICIQ-SF), International Consultation on Incontinence-OAB (ICIQ-OAB), Symptom bother, and 3-day Voiding diary at weeks 0, 12, and 24. Results: The groups were similar before treatment. After treatment, all groups significantly improved in OAB symptoms and quality of life (QoL). At week 12, ICIQ-OAB scores were 5.9, 4.6, and 2.9, in groups I, II, and III, respectively, p = 0.01. At week 24, GI and GIII kept the scores of the end of treatment (week 12), while GII increased ICIQ-OAB from 4.6 to 9.2, p = 0.0001, ICIQ-SF from 9.8 to 13.3, p = 0.0006, and Symptom bother score from 3.4 to 7.0, p = 0.0001. Conclusions: The multimodal treatment was more effective and TENS alone or in association presented longer lasting results for improvement of clinical symptoms of OAB and QoL. © 2013 Springer-Verlag Berlin Heidelberg.321179184Abrams, P., Cardozo, L., Fall, M., The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society (2002) Neurourol Urodyn, 21, pp. 167-178Abrams, P., Cardozo, L., Wein, A., 3rd international consultation on incontinence-research society 2011 (2012) Neurourol Urodyn, 31, pp. 291-292Bellette, P.O., Rodrigues Palma, P.C., Hermann, V., Posterior tibial nerve stimulation in the management of overactive bladder: a prospective and controlled study (2009) Actas Urol Esp, 33, pp. 58-63Mattiasson, A., Blaakaer, J., Hoye, K., Simplified bladder training augments the effectiveness of tolterodine in patients with an overactive bladder (2003) BJU Int, 91, pp. 154-160Burton, C., Sajja, A., Latthe, P.M., Effectiveness of percutaneous posterior tibial nerve stimulation for overactive bladder: a systematic review and meta-analysis (2012) Neurourol Urodyn, 31, pp. 1206-1216Rai, B.P., Cody, J.D., Alhasso, A., Anticholinergic drugs versus non-drug active therapies for non-neurogenic overactive bladder syndrome in adults (2012) Cochrane Database Syst Rev, 12, pp. CD003193Pelletier, E.M., Vats, V., Clemens, Q., Pharmacotherapy adherence and costs versus nonpharmacologic management in overactive bladder (2009) Am J Manag Care, 15, pp. S108-S114Anderson, K.E., Antimuscarinics for treatment of overactive bladder (2004) Lancet Neurol, 3, pp. 46-53Govier, F.E., Litwiller, S., Nitti, V., Percutaneous afferent neuromodulation for the refractory overactive bladder: results of a multicenter study (2001) J Urol, 165, pp. 1193-1198Peters, K.M., MacDiarmid, S.A., Wooldridge, L.S., Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial (2009) J Urol, 182, pp. 1055-1061Tellenbach, M., Schneider, M., Mordasini, L., Transcutaneous electrical nerve stimulation: an effective treatment for refractory non-neurogenic overactive bladder syndrome? (2012) World J Urol, , doi:10.1007/s00345-012-0888-zGoode, P.S., Burgio, K.L., Locher, J.L., Urodynamic changes associated with behavioral and drug treatment of urge incontinence in older women (2002) J Am Geriatr Soc, 50, pp. 808-816MacDiarmid, S.A., Peters, K.M., Shobeiri, S.A., Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder (2010) J Urol, 183, pp. 234-240Levin, P.J., Wu, J.M., Kawasaki, A., The efficacy of posterior tibial nerve stimulation for the treatment of overactive bladder in women: a systematic review (2012) Int Urogynecol J, 23, pp. 1591-1597