In a nutshell
This study examined the effectiveness of posterior tibial nerve stimulation (PTNS) in treating overactive bladders in patients with multiple sclerosis. Researchers concluded that overactive bladder symptoms can be significantly reduced with PTNS.
Some background
Urinary function is coordinated by the nervous system. Diseases of the nervous system, such as multiple sclerosis, can therefore cause urinary symptoms. The most common urinary symptom in patients with multiple sclerosis is an overactive bladder, which is associated with severe urinary urgency.
Posterior tibial nerve stimulation (PTNS) is a type of nerve stimulation used to help control urinary urgency. PTNS involves a minimally invasive procedure during which a needle electrode is inserted into the posterior tibial nerve at the ankle. The electrode sends signals to the sacral plexus, a nerve which regulates the control of bladder and pelvic floor muscles. It is an alternative treatment option for patients who do not respond to, or tolerate, standard drug therapy.
Methods & findings
The aim of this study was to examine PTNS as a treatment for overactive bladders in patients with multiple sclerosis.
34 patients with overactive bladders due to multiple sclerosis were included in this study. All patients were treated with weekly PTNS treatments for 12 weeks. After 12 weeks, PTNS treatment frequency was reduced to 14-day intervals for 3 months, 21-day intervals for 3 months, and 28-day intervals for another 3 months. 21 patients completed the 1-year PTNS treatment.
Patients recorded the number of voids (bladder emptying) per day. The number of voids was significantly reduced at 6, 9, and 12 months. At 12 months, the number of voids per day was reduced by an average of 5.4. The average number of urge incontinence episodes per day was reduced by 3.4 at 12 months. Urgency episodes decreased by an average of 7.4 episodes per day. Voids during nighttime (also called nocturia) were reduced by 2.6 on average. Bladder emptying was significantly improved at 12 months. The volume of urine voided increased by an average of 72.1 cubic centimeters. Patients also reported significant improvements in symptom severity and quality of life.
No serious treatment-related side effects were observed. 3 patients reported mild to moderate pain in the injection site, leg cramps, and tingling in the legs.
The bottom line
Researchers concluded that overactive bladder symptoms can be significantly reduced with PTNS.
The fine print
Larger studies are needed to confirm these results.
Published By :
Neurourology and urodynamics
Date :
Jan 01, 2017
