title: Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study.
abstract: OBJECTIVE
  Electrostimulation is an established therapeutic option for neurogenic urinary disorders. The aim of this study was to investigate the efficacy of the noninvasive technique of transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with multiple sclerosis (MS) and troublesome symptoms of an overactive bladder (OAB).
  
  
  METHODS
  A multicentric study enrolled 70 MS patients, suffering from OAB for a 3-month study period.
  
  
  METHODS
  Daily sessions of 20 min of TPTNS were provided. No change of associated treatments during the study period. The primary outcome measurement was Urgency and Frequency reported by bladder diary and symptom score performed before the treatment (Day 0, D0) and at D30 and D90. The secondary outcomes measurements were continence, symptom score, quality of life, psychosocial burden at DO, D30, and D90 and cystometry at baseline, with and without TPTNS and at D90.
  
  
  RESULTS
  Clinical improvement of OAB was shown in 82.6% and 83.3% of the patients on D30 and D90, respectively, with significant improvement of primary and secondary outcomes compared to baseline. The initial acute cystometric response to TPTNS was positive in 51.2% of the patients (increase of >30% of cystometric capacity and/or reflex volume), without correlation with TPTNS clinical efficiency. The procedure was well tolerated.
  
  
  CONCLUSIONS
  Chronic TPTNS appears to be effective in the management of severe OAB in MS, without compromising bladder emptying or inducing side effect. Treatment may be effective even in the absence of an acute cystometric effect. Additional works are required to demonstrate long-term efficacy of TPTNS.
authors.affiliation: Physical Medicine and Neurorehabilitation Unit, Bordeaux University Hospital, EA 4136, Bordeaux University, Bordeaux, France. mariannedeseze@yahoo.fr
authors.forename: Marianne
authors.initials: M
authors.lastname: de Sèze
authors.forename: Patrick
authors.initials: P
authors.lastname: Raibaut
authors.forename: Philippe
authors.initials: P
authors.lastname: Gallien
authors.forename: Alexia
authors.initials: A
authors.lastname: Even-Schneider
authors.forename: Pierre
authors.initials: P
authors.lastname: Denys
authors.forename: Veronique
authors.initials: V
authors.lastname: Bonniaud
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
authors.forename: Gérard
authors.initials: G
authors.lastname: Amarenco
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D017281:Cost of Illness; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013979:Tibial Nerve; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation*; D053201:Urinary Bladder, Overactive / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics