Motor and sensory responses after percutaneous tibial nerve stimulation in multiple sclerosis patients with lower urinary tract symptoms treated in daily practice

European Journal of Neurology (Impact Factor: 4.06). 01/2014; DOI: 10.1111/ene.12339
Source: PubMed


Posterior tibial nerve stimulation (PTNS) is an effective treatment option for lower urinary tract symptoms (LUTS) in multiple sclerosis (MS) patients.
Patients with MS and LUTS unresponsive to medical treatment received PTNS for 12 weeks after saline urodynamics to evaluate the prevalence of motor, sensory and combined responses during PTNS and to determine whether the type of response can predict treatment outcome. LUTS were also assessed using a 3-day bladder diary, patient perception of bladder condition (PPBC) questionnaire, patient perception of intensity of urgency scale (PPIUS), Kings Health QOL questionnaire (KHQ) and Overactive Bladder Questionnaire (OAB-q) before and after treatment. Patients were considered as "responders" if they reported an improvement >50% in their LUTS according to the PPBC. Sensory, motor and combined sensory/motor responses were compared between responders and non-responders.
Eighty-three patients were included. 61% (51/83) of patients were responders. Sensory, motor and combined sensory/motor responses were found in 64% (53/83), 6% (5/83) and 30% (25/83) of patients respectively. A sensory response alone, or in combination with a motor response, was better associated with a successful outcome than the presence of a motor response alone (P = 0.001).
A sensory response, either alone or in combination with a motor response, is more frequent and seems to be better associated with a successful outcome of PTNS than motor response alone.

Download full-text


Available from: Chiara Zecca, Mar 16, 2014

  • International Urogynecology Journal 04/2014; 25(8). DOI:10.1007/s00192-014-2378-x · 1.96 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Over the last 10 years, there have been an increasing number of treatment options for patients with neurogenic bladder. We conducted a literature review of the most current research on mirabegron, onabotulinumtoxin A, sacral nerve modulation (SNM), and posterior tibial nerve stimulation (PTNS) as it pertains to neurogenic bladder. In addition to discussing these treatments, we also discuss how these treatments pertain to the most common etiologies of neurogenic bladder: multiple sclerosis (MS), spinal cord injury (SCI) and Parkinson’s Disease. Each of the above treatment modalities has been shown to be effective in these populations, with the most research behind onabotulinumtoxin A. While SNM and PTNS appear promising, more research is needed with bigger populations to fully elucidate the benefits of these treatments. The decision on which treatment is best for each patient should be individualized based on a patient’s symptoms, disease, and his or her unique preferences.
    Current Bladder Dysfunction Reports 03/2015; 10(1). DOI:10.1007/s11884-014-0282-3