Can nerve stimulation improve urinary function in multiple sclerosis?

This study examined the effectiveness of nerve stimulation in the treatment of urinary incontinence in patients with multiple sclerosis.

Researchers concluded that pelvic nerve stimulation (following the LION procedure) can improve symptoms of urinary incontinence in some cases of multiple sclerosis.

The LION procedure (acronym for laparoscopic implantation of neuromodulation electrodes) is a surgery for the treatment of urinary dysfunction that, specifically, stems from problems of the central nervous system. It is a less invasive alternative to open surgery, and involves inserting a small electrical stimulator under the skin. The stimulator supplies an electrical current to the nerves for optimal pelvic muscle activation. Correct pelvic muscle activation is needed for bladder control.

Studies have shown that the LION procedure is an effective treatment for urinary dysfunction in patients with spinal cord injury. It is unclear whether this procedure may also help patients with other diseases of the central nervous system, such as multiple sclerosis.

Urinary symptoms of two women with multiple sclerosis were analyzed before and after the LION procedure. Surgical outcomes were followed-up for one year. Both women suffered from urinary incontinence before the surgery.

After the LION procedure, both patients experienced a full recovery of urinary incontinence. General mobility also improved in both patients as a result of the surgery.

At one-year follow-up, the patient with more advanced multiple sclerosis still reported the same improvements in her urinary function. She also no longer experienced bladder infections (compared to 4-6 infections per year before the surgery). The second patient had a relapse of her urinary symptoms 9 months after the LION procedure. Even after numerous attempts to reset the stimulator, she continued to experience incontinence.

Researchers concluded that pelvic nerve stimulation following the LION procedure can improve urinary function in some patients with multiple sclerosis. However, researchers advise patients that multiple sclerosis is a progressive disease. Therefore, any positive outcomes from the LION procedure may fade over time.

Large clinical trials are needed to confirm the results of this preliminary study (consisting of only two case reports).