Percutaneous posterior tibial nerve stimulation as an effective treatment of refractory lower urinary tract symptoms in patients with multiple sclerosis: preliminary data from a multicentre, prospective, open label trial

Mult Scler. 2011 Dec;17(12):1514-9. doi: 10.1177/1352458511414040. Epub 2011 Jul 14.

Abstract

Background: Percutaneous tibial nerve stimulation (PTNS) has been proposed as a new, minimally invasive neuromodulation technique to treat lower urinary tract symptoms (LUTS).

Objective: To evaluate efficacy, safety and impact on quality of life (QoL) of PTNS on patients with multiple sclerosis (MS) who have LUTS.

Methods: 21 patients (5 men, 16 women) with MS and LUTS unresponsive to anticholinergics were treated with 12 sessions of PTNS. Assessment of LUTS was by validated, self-administered chart and questionnaires, testing the subjective and objective relevance of LUTS for patients and their impact on QoL before and after treatment; the mean post-micturition residual was assessed by trans-abdominal ultrasound scanning. Analysis was by intention to treat.

Results: There was a significant reduction of daytime frequency (from 9 to 6, p = 0.04), nocturia (from 3 to 1, p = 0.002) and mean post-micturition residual (from 98 ± 124 ml to 43 ± 45 ml, p = 0.02). The mean voided volume increased from 182 ± 50 ml to 225 ± 50 ml (p = 0.003). Eighty-nine percent of patients reported a treatment satisfaction of 70%. Significant improvement in QoL was seen in most domains of the King's Health QoL questionnaire (p < 0.05). No adverse events were reported.

Conclusions: PTNS is an effective, safe and well-tolerated treatment for LUTS in patients with MS.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Electric Stimulation Therapy*
  • Female
  • Humans
  • Lower Urinary Tract Symptoms / complications
  • Lower Urinary Tract Symptoms / therapy*
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires
  • Tibial Nerve / physiology*
  • Treatment Outcome
  • Urinary Incontinence / therapy