title: Efficacy of peripheral lidocaine application (neural therapy) in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients.
abstract: OBJECTIVE
  Many agents and treatments are used in the treatment of neurogenic detrusor overactivity (NDO) in MS patients, but no study has been conducted on the use of peripheric lidocaine (neural therapy-NT) on MS patients. We evaluated the effects of local administration of lidocaine on NDO in Multiple Sclerosis (MS) patients.
  
  
  METHODS
  For each patient local anesthetic lidocaine was injected at each session. Sessions were held once a week for 5 weeks. At each session, Th 10-L1, urogenital segment intradermal injections, Frankenhauser, and sacral epidural injections were given. The patients had clinical and urodynamic assessment 1 month before and 3, 9, and 12 months after NT. In addition, multiple sclerosis quality of life inventory (MSQL-54) and bladder control scale (BLCS) was performed for patients.
  
  
  RESULTS
  Twenty-eight patients were included in the study (8 males, 20 females). The patients' average age was 31.7 ± 8.1 years. The injection therapy significantly improved volume at first involuntary bladder contraction (FCV), maximal detrusor pression during filling (P det. max.), maximal cystometric bladder capacity (MCC) after 3 months. Also, the MSQL-54 and BLCS scores were improved with treatment. However, these improvements reached a maximum 3 months after treatment, but from the 9 month a regression was seen in the parameters, and after 12 months the findings were seen to be slightly above their basal levels.
  
  
  CONCLUSIONS
  These results suggest that NDO treatment in MS patients could be an effective treatment which is easy and has very few side effects, and is cost effective.
authors.affiliation: Department of Neurology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Tamam
authors.affiliation: Department of Neurology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Hasan Hüseyin
authors.initials: HH
authors.lastname: Özdemir
authors.affiliation: Department of Urology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Gedik
authors.affiliation: Private practice, Istanbul, Turkey.
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Tamam
authors.affiliation: Private practice, Istanbul, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Nazlıkul
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D007271:Injections, Intradermal; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000209:etiology; D014563:Urodynamics / Q000187:drug effects; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: incontinence; lidocaine; multiple sclerosis; neural therapy; neurogenic detrusor overactivity