title: Percutaneous posterior tibial nerve stimulation as an effective treatment of refractory lower urinary tract symptoms in patients with multiple sclerosis: preliminary data from a multicentre, prospective, open label trial.
abstract: BACKGROUND
  Percutaneous tibial nerve stimulation (PTNS) has been proposed as a new, minimally invasive neuromodulation technique to treat lower urinary tract symptoms (LUTS).
  
  
  OBJECTIVE
  To evaluate efficacy, safety and impact on quality of life (QoL) of PTNS on patients with multiple sclerosis (MS) who have LUTS.
  
  
  METHODS
  21 patients (5 men, 16 women) with MS and LUTS unresponsive to anticholinergics were treated with 12 sessions of PTNS. Assessment of LUTS was by validated, self-administered chart and questionnaires, testing the subjective and objective relevance of LUTS for patients and their impact on QoL before and after treatment; the mean post-micturition residual was assessed by trans-abdominal ultrasound scanning. Analysis was by intention to treat.
  
  
  RESULTS
  There was a significant reduction of daytime frequency (from 9 to 6, p = 0.04), nocturia (from 3 to 1, p = 0.002) and mean post-micturition residual (from 98 ± 124 ml to 43 ± 45 ml, p = 0.02). The mean voided volume increased from 182 ± 50 ml to 225 ± 50 ml (p = 0.003). Eighty-nine percent of patients reported a treatment satisfaction of 70%. Significant improvement in QoL was seen in most domains of the King's Health QoL questionnaire (p < 0.05). No adverse events were reported.
  
  
  CONCLUSIONS
  PTNS is an effective, safe and well-tolerated treatment for LUTS in patients with MS.
authors.affiliation: Neurocentre of Southern Switzerland, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland. claudio.gobbi@eoc.ch
authors.forename: C
authors.initials: C
authors.lastname: Gobbi
authors.forename: G A
authors.initials: GA
authors.lastname: Digesu
authors.forename: V
authors.initials: V
authors.lastname: Khullar
authors.forename: S
authors.initials: S
authors.lastname: El Neil
authors.forename: G
authors.initials: G
authors.lastname: Caccia
authors.forename: C
authors.initials: C
authors.lastname: Zecca
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013979:Tibial Nerve / Q000502:physiology*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy