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Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: Results of a multicenter prospective study
Author(s) -
de Sèze Marianne,
Raibaut Patrick,
Gallien Philippe,
EvenSchneider Alexia,
Denys Pierre,
Bonniaud Veronique,
Gamé Xavier,
Amarenco Gérard
Publication year - 2011
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20958
Subject(s) - medicine , overactive bladder , quality of life (healthcare) , prospective cohort study , urology , constipation , urinary system , tibial nerve , multiple sclerosis , cystometry , clinical endpoint , urinary bladder , surgery , stimulation , clinical trial , alternative medicine , nursing , pathology , psychiatry
Aims Electrostimulation is an established therapeutic option for neurogenic urinary disorders. The aim of this study was to investigate the efficacy of the noninvasive technique of transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with multiple sclerosis (MS) and troublesome symptoms of an overactive bladder (OAB). Methods A multicentric study enrolled 70 MS patients, suffering from OAB for a 3‐month study period. Intervention : Daily sessions of 20 min of TPTNS were provided. No change of associated treatments during the study period. The primary outcome measurement was Urgency and Frequency reported by bladder diary and symptom score performed before the treatment (Day 0, D0) and at D30 and D90. The secondary outcomes measurements were continence, symptom score, quality of life, psychosocial burden at DO, D30, and D90 and cystometry at baseline, with and without TPTNS and at D90. Results Clinical improvement of OAB was shown in 82.6% and 83.3% of the patients on D30 and D90, respectively, with significant improvement of primary and secondary outcomes compared to baseline. The initial acute cystometric response to TPTNS was positive in 51.2% of the patients (increase of >30% of cystometric capacity and/or reflex volume), without correlation with TPTNS clinical efficiency. The procedure was well tolerated. Conclusions Chronic TPTNS appears to be effective in the management of severe OAB in MS, without compromising bladder emptying or inducing side effect. Treatment may be effective even in the absence of an acute cystometric effect. Additional works are required to demonstrate long‐term efficacy of TPTNS. Neurourol. Urodynam. 30:306–311, 2011. © 2011 Wiley‐Liss, Inc.