SINGLE CENTRE RANDOMISED PILOT STUDY OF TWO REGIMENS (30 MINS DAILY OR 30 MINS WEEKLY FOR 12 WEEKS) OF TRANSCUTANEOUS TIBIAL NERVE STIMULATION USING A NOVEL DEVICE FOR TREATING MULTIPLE SCLEROSIS-RELATED OVERACTIVE BLADDER SYMPTOMS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.20-e4 ◽  
Author(s):  
Jai Seth ◽  
Collette Haslam ◽  
Gwen Gonzales ◽  
Mahreen Pakzad ◽  
Arvind Vashisht ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Pilot Study ◽  
Overactive Bladder ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Multilevel Regression ◽  
Single Centre ◽  
Novel Device ◽  
Tibial Nerve Stimulation ◽  
Bladder Symptoms

IntroductionPercutaneous tibial nerve stimulation (PTNS) is effective for managing multiple sclerosis (MS)-related overactive bladder (OAB) symptoms. However the need for weekly clinic visits restricts its use. The purpose of this study was to evaluate safety and efficacy of a novel, self-applying device for managing OAB symptoms.Study design, materials and methods48 patients reporting OAB (MS n=24, idiopathic n=24), were randomized (1:1) to either daily or weekly treatments for 12 weeks with geko™, a novel device stimulating the tibial nerve transcutaneously. Efficacy was assessed using validated questionnaires (ICIQ-OAB, ICIQLUTS-QoL) and bladder diaries filled at weeks 4, 8, and 12. Urinary neurotrophins (Nerve growth factor (NGF) and Brain derived neurotrophic factor) were measured.Results34 patients (MS n=19) completed the study. 18 patients responded to treatment (53%); 72% of responders belonged to the MS cohort. Multilevel regression analysis suggested significant improvements in questionnaire scores (ICIQ-OAB –10.2 (–13.5 to –6.9; p=0.001), ICIQLUTS-QOL –40.8 (–57.4 to –24.3; p=0.000)), without differences between weekly and daily-treated arms. No significant adverse effects were reported and patients rated the treatment as easy to use and comfortable. NGF levels at baseline were significantly greater in non-responders (p=0.05).Concluding messageIn this pilot study, a patch device suitable for self-application at home appears to be an effective, safe and convenient alternative for managing MS-related OAB symptoms.

scholarly journals Neuromodulation for functional bladder disorders in patients with multiple sclerosis

2019 ◽  
Vol 26 (11) ◽  
pp. 1274-1280 ◽  
Author(s):  
Mohammad Sajjad Rahnama’i
Keyword(s):  
Multiple Sclerosis ◽  
Nervous System ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Disease Onset ◽  
Tibial Nerve Stimulation ◽  
Urological Symptoms ◽  
Bladder Symptoms ◽  
Bladder Disorders

The function of the lower urinary tract is mainly storage and voiding of urine, which is coordinated by the nervous system. Various diseases of the nervous system may cause neuro-urological symptoms. Neuro-urological symptoms depend on the localization of the disease and the extension of the neurological lesion. About 80% of multiple sclerosis (MS) patients have neuro-urological symptoms within 10 years after diagnosis. In addition, 10% of MS patients may even present with voiding dysfunction at disease onset. In this review, different types of neuromodulation are discussed. The available studies suggest that sacral neuromodulation (SNM) and percutaneous tibial nerve stimulation (PTNS) may be helpful in the neuromodulation of MS-related overactive bladder symptoms. These techniques may not only decrease the severity of symptoms but also significantly improve the quality of life of affected patients. Exploring the role of implantable tibial nerve stimulation devices in patients with MS could open new doors in the management of urgency and urgency incontinence in this patient group.

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

2020 ◽  
pp. 135245852092666
Author(s):  
Cansu Polat Dunya ◽  
Zeliha Tulek ◽  
Murat Kürtüncü ◽  
Jalesh N Panicker ◽  
Mefkure Eraksoy
Keyword(s):  
Multiple Sclerosis ◽  
Overactive Bladder ◽  
Pelvic Floor ◽  
Nerve Stimulation ◽  
Pelvic Floor Muscle Training ◽  
Tibial Nerve ◽  
Pelvic Floor Muscle ◽  
Treatment Options ◽  
Muscle Training ◽  
Tibial Nerve Stimulation

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.

Sign in / Sign up

Export Citation Format

Share Document