Maintenance Percutaneous Posterior Nerve Stimulation for Refractory Lower Urinary Tract Symptoms in Patients with Multiple Sclerosis: An Open Label, Multicenter, Prospective Study
2013; Lippincott Williams & Wilkins; Volume: 191; Issue: 3 Linguagem: Inglês
10.1016/j.juro.2013.09.036
ISSN1527-3792
AutoresChiara Zecca, G. Alessandro Digesu, P. Robshaw, Anubha Singh, Sohier Elneil, Claudio Gobbi,
Tópico(s)Anorectal Disease Treatments and Outcomes
ResumoNo AccessJournal of UrologyAdult Urology1 Mar 2014Maintenance Percutaneous Posterior Nerve Stimulation for Refractory Lower Urinary Tract Symptoms in Patients with Multiple Sclerosis: An Open Label, Multicenter, Prospective Study C. Zecca, G.A. Digesu, P. Robshaw, A. Singh, S. Elneil, and C. Gobbi C. ZeccaC. Zecca Neurocentre of Italian Switzerland, Lugano, Switzerland , G.A. DigesuG.A. Digesu Neurocentre of Italian Switzerland, Lugano, Switzerland Urogynaecology Unit, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Mendrisio, Switzerland St. Mary's Hospital, Imperial College School of Medicine, London, United Kingdom National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom , P. RobshawP. Robshaw St. Mary's Hospital, Imperial College School of Medicine, London, United Kingdom , A. SinghA. Singh St. Mary's Hospital, Imperial College School of Medicine, London, United Kingdom , S. ElneilS. Elneil National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom , and C. GobbiC. Gobbi Neurocentre of Italian Switzerland, Lugano, Switzerland View All Author Informationhttps://doi.org/10.1016/j.juro.2013.09.036AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Percutaneous tibial nerve stimulation is an effective second line therapy for lower urinary tract symptoms. Data on percutaneous tibial nerve stimulation maintenance treatment are scarce. In this study we evaluate its effectiveness and propose an algorithm of percutaneous tibial nerve stimulation maintenance treatment in patients with multiple sclerosis. Materials and Methods: In this prospective, multicenter, open label trial consecutive patients with multiple sclerosis and lower urinary tract symptoms unresponsive to medical therapy were treated with 12 weekly sessions of percutaneous tibial nerve stimulation. Responder patients (50% or greater improvement of lower urinary tract symptoms as measured by the patient perception of bladder condition questionnaire) entered a maintenance phase with individualized treatment frequency based on patient response. Lower urinary tract symptoms were assessed using a 3-day frequency volume chart, urodynamics and patient perception of bladder condition questionnaire. Treatment satisfaction was evaluated using a global response assessment scale and a treatment satisfaction visual analog scale. Results: A total of 83 patients were included in the study and 74 (89%) responded to initial treatment. Persistent efficacy occurred in all initial responders after a mean treatment of 24 months. The greatest frequency of maintenance percutaneous tibial nerve stimulation was every 2 weeks. Lower urinary tract symptoms and patient treatment satisfaction improved with time compared to initial treatment (p <0.05). Bladder diary parameters and voiding parameters improved compared to baseline (p <0.05). Conclusions: Prolonged percutaneous tibial nerve stimulation treatment leads to a persistent improvement of lower urinary tract symptoms in patients with multiple sclerosis. References 1 : Bladder, bowel and sexual dysfunction in patients with multiple sclerosis–a cohort study. Scand J Urol Nephrol Suppl1996; 179: 61. Google Scholar 2 : Role of urologist in diagnosis of multiple sclerosis. Urology1991; 37: 311. Google Scholar 3 : The overactive bladder in multiple sclerosis. J Am Osteopath Assoc2000; 100: S9. Google Scholar 4 : Role of limited evaluation and aggressive medical management in multiple sclerosis: a review of 113 patients. J Urol1994; 151: 946. 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Link, Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byWein A (2019) Re: Tibial Nerve and Sacral Neuromodulation in the Elderly PatientJournal of Urology, VOL. 203, NO. 3, (469-469), Online publication date: 1-Mar-2020.Wein A (2018) Re: Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic ReviewJournal of Urology, VOL. 197, NO. 1, (217-218), Online publication date: 1-Jan-2017.Steers W (2018) This Month in Adult UrologyJournal of Urology, VOL. 191, NO. 3, (571-572), Online publication date: 1-Mar-2014.Lemack G (2018) Percutaneous Tibial Nerve Stimulation for Refractory Lower Urinary Tract Symptoms in Patients with Neurogenic Bladder ConditionsJournal of Urology, VOL. 191, NO. 3, (582-583), Online publication date: 1-Mar-2014. Volume 191Issue 3March 2014Page: 697-702 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordstranscutaneous electric nerve stimulationurinary incontinencemultiple sclerosisurination disordersAcknowledgmentsLiliane Petrini provided assistance.MetricsAuthor Information C. Zecca Neurocentre of Italian Switzerland, Lugano, Switzerland Nothing to disclose. More articles by this author G.A. Digesu Neurocentre of Italian Switzerland, Lugano, Switzerland Urogynaecology Unit, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Mendrisio, Switzerland St. Mary's Hospital, Imperial College School of Medicine, London, United Kingdom National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom Nothing to disclose. More articles by this author P. Robshaw St. Mary's Hospital, Imperial College School of Medicine, London, United Kingdom Nothing to disclose. More articles by this author A. Singh St. Mary's Hospital, Imperial College School of Medicine, London, United Kingdom Nothing to disclose. More articles by this author S. Elneil National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom Financial interest and/or other relationship with Medtronic, Allergan and Astellas. More articles by this author C. Gobbi Neurocentre of Italian Switzerland, Lugano, Switzerland Nothing to disclose. More articles by this author Expand All Advertisement PDF downloadLoading ...
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