Evaluating the effects of transcutaneous tibial nerve stimulation or pelvic floor muscle training on sexual dysfunction in female multiple sclerosis patients reporting overactive bladder

Background: Overactive bladder (OAB) is common in patients with multiple sclerosis (MS) with a limited number of treatment options. Objective: To investigate the effect of transcutaneous tibial nerve stimulation (TTNS) and pelvic floor muscle training (PFMT) with biofeedback on OAB symptoms in female MS patients. Methods: This study was conducted at the outpatient MS clinic in Istanbul. At baseline bladder diary, post-voiding residue (PVR), OAB, and Qualiveen Scales (QoL: Quality of Life; Siup: Specific Impact of Urinary Problems on QoL) were assessed. Patients were allocated to receive TTNS or PFMT daily for 6 weeks and reevaluated using the same tests. Results: Fifty-five patients (TTNS = 28, PFMT = 27) were included. Compared with baseline, both TTNS and PFMT groups improved in terms of OAB ( p = 0.0001, p = 0.0001), Qualiveen-siup ( p = 0.0001, p = 0.0001), Qualiveen-QoL ( p = 0.002, p = 0.006), PVR ( p = 0.0001, p = 0.21), frequency ( p = 0.0001, p = 0.69), nocturia ( p = 0.0001, p = 0.19), urgency ( p = 0.0001, p = 0.0001), and urge incontinence ( p = 0.0001, p = 0.0001). Between-group comparisons showed significant differences in 24-hour frequency ( p = 0.002) in favor of TTNS. Conclusion: Our study demonstrates the efficacy of both TTNS and PFMT for managing OAB symptoms in MS, associated with a significant impact on QoL, but did not show superiority of the methods. Further studies are needed to explore differences between these two non-invasive treatments.

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CORRIGENDUM to “Effectiveness of the transcutaneous tibial nerve stimulation and pelvic floor muscle training with biofeedback in women with multiple sclerosis for the management of overactive bladder”

Multiple Sclerosis Journal ◽

10.1177/1352458520945512 ◽

2020 ◽

Vol 26 (10) ◽

pp. 1270-1270

Keyword(s):

Multiple Sclerosis ◽

Overactive Bladder ◽

Pelvic Floor ◽

Nerve Stimulation ◽

Pelvic Floor Muscle Training ◽

Tibial Nerve ◽

Pelvic Floor Muscle ◽

Muscle Training ◽

Tibial Nerve Stimulation

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Pelvic Floor Muscle Training and Neurogenic Overactive Bladder in Stroke and Multiple Sclerosis

Urodynamics, Neurourology and Pelvic Floor Dysfunctions - Suprapontine Lesions and Neurogenic Pelvic Dysfunctions ◽

10.1007/978-3-030-29775-6_9 ◽

2019 ◽

pp. 93-105

Author(s):

Kari Bø

Keyword(s):

Multiple Sclerosis ◽

Overactive Bladder ◽

Pelvic Floor ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Muscle Training

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Evaluation of satisfaction of pelvic floor muscle training isolated and associated with tibial nerve stimulation in women with mixed urinary incontinence: a randomized, single-blinded clinical trial

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2021.06.024 ◽

2021 ◽

Author(s):

Maria Clara Oliveira ◽

Maiara Oliveira ◽

Halana Silva ◽

Adriana Gomes ◽

Grasiéla Nascimento ◽

...

Keyword(s):

Clinical Trial ◽

Urinary Incontinence ◽

Pelvic Floor ◽

Nerve Stimulation ◽

Pelvic Floor Muscle Training ◽

Tibial Nerve ◽

Pelvic Floor Muscle ◽

Mixed Urinary Incontinence ◽

Muscle Training ◽

Tibial Nerve Stimulation

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The effect of pelvic floor muscle training alone or in combination with electrostimulation in the treatment of sexual dysfunction in women with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458514531520 ◽

2014 ◽

Vol 20 (13) ◽

pp. 1761-1768 ◽

Cited By ~ 20

Author(s):

AC Lúcio ◽

CAL D’Ancona ◽

MHBM Lopes ◽

MC Perissinotto ◽

BP Damasceno

Keyword(s):

Multiple Sclerosis ◽

Sexual Dysfunction ◽

Sexual Function ◽

Pelvic Floor ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Emg Biofeedback ◽

Vaginal Opening ◽

Muscle Training ◽

Group Ii

Background: Sexual dysfunction (SD) affects up to 80% of multiple sclerosis (MS) patients and pelvic floor muscles (PFMs) play an important role in the sexual function of these patients. Objectives: The objective of this paper is to evaluate the impact of a rehabilitation program to treat lower urinary tract symptoms on SD of women with MS. Methods: Thirty MS women were randomly allocated to one of three groups: pelvic floor muscle training (PFMT) with electromyographic (EMG) biofeedback and sham neuromuscular electrostimulation (NMES) (Group I), PFMT with EMG biofeedback and intravaginal NMES (Group II), and PFMT with EMG biofeedback and transcutaneous tibial nerve stimulation (TTNS) (Group III). Assessments, before and after the treatment, included: PFM function, PFM tone, flexibility of the vaginal opening and ability to relax the PFMs, and the Female Sexual Function Index (FSFI) questionnaire. Results: After treatment, all groups showed improvements in all domains of the PERFECT scheme. PFM tone and flexibility of the vaginal opening was lower after the intervention only for Group II. All groups improved in arousal, lubrication, satisfaction and total score domains of the FSFI questionnaire. Conclusion: This study indicates that PFMT alone or in combination with intravaginal NMES or TTNS contributes to the improvement of SD.

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Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.12.1032 ◽

2017 ◽

Vol 63 (12) ◽

pp. 1032-1038 ◽

Cited By ~ 2

Author(s):

Fátima Fitz ◽

Marair Sartori ◽

Manoel João Girão ◽

Rodrigo Castro

Keyword(s):

Quality Of Life ◽

Overactive Bladder ◽

Pelvic Floor ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Urinary Symptoms ◽

Life Questionnaire ◽

Muscle Training ◽

Pad Test

Summary Introduction: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. Objective: To verify the effects of isolated PFMT on the symptoms of OAB. Method: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-of-Life Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. Results: There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003). In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. Conclusion: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.

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