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Percutaneous Posterior Tibial Nerve Stimulation (Ptns) for Lower Urinary Tract Symptoms (Lutss) Treatment in Patients With Multiple Sclerosis (Ms): A Systematic Review and Meta-Analysis Publisher Pubmed



Guitynavard F1 ; Mirmosayyeb O2, 3 ; Razavi ERV4, 5 ; Hosseini M5 ; Hosseinabadi AM6 ; Ghajarzadeh M7, 8 ; Azadvari M9
Authors
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Authors Affiliations
  1. 1. Urology Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Physical Medicine and Rehabilitation Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  9. 9. Physical Medicine and Rehabilitation Department, Sina & Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Multiple Sclerosis and Related Disorders Published:2022


Abstract

Background: Lower urinary tract symptoms (LUTSs) are common in patients with multiple sclerosis (MS). Percutaneous posterior tibial nerve stimulation (PTNS) is a minimally invasive treatment which is considered to be effective for patients who suffer from LUTS symptoms. In previous studies, the endpoints of treatment reported differently. So, we designed this systematic review and meta-analysis to estimate pooled efficacy of PTNS based on different assessment methods. Methods: We systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar. We also searched the gray literature including references of the included studies, and conference abstracts which were published up to May 2021. The search strategy included the MeSH and text words as (((Tibial Nerves) OR Posterior Tibial Nerve) OR (Posterior Tibial Nerves) OR (Medial Plantar Nerves) OR (Medial Plantar Nerve) OR (tibial Nerve Stimulation) OR (Trans-Cutaneous Tibial Nerve Stimulation) OR (Percutaneous Tibial Nerve Stimulation) OR (Cutaneous Tibial Nerve Stimulation) AND ((Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Disseminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating).Two independent researchers independently evaluated the articles. Results: We found 2430 articles by literature search, after deleting duplicates 2027 remained. Eight articles remained for meta-analysis The pooled SMD of post voiding residual (PVR) (post-treatment – pre-treatment) was -0.75 (95%CI:-0.93, -0.56)(I2=0, p = 0.67). The pooled SMD of voiding volume (post-treatment – pre-treatment) was 1.21 (95% CI:0.94–1.49) (I2:0%, p = 0.4). The pooled SMD of nocturia (post-treatment – pre-treatment) was -1.10 (95% CI:-1.33, -0.87) (I2:86.4%, p<0.001). The pooled SMD of leakage per day (post-treatment – pre-treatment) was -0.69 (95% CI:–0.93, -0.45) (I2:84.3%, p<0.001). The pooled frequency of responders was 66%(95% CI:59%-73%)(I2:0). Conclusion: The results of this systematic review and meta-analysis show that PTNS in effective in treating LUTS in patients with MS. © 2021 Elsevier B.V.
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1. The Prevalence of Lower Urinary Tract Symptoms Based on Individual and Clinical Parameters in Patients With Multiple Sclerosis, BMC Neurology (2020)
2. Transcutaneous Electrical Nerve Stimulation in Female Stress Urinary Incontinence, Journal of Research in Medical Sciences (2006)
3. Research Paper: Comparison of Bladder Dysfunction and Urinary Symptoms Between Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder, Caspian Journal of Neurological Sciences (2019)
4. Association of Urodynamic Findings in New Onset Multiple Sclerosis With Subsequent Occurrence of Urinary Symptoms and Acute Episode of Disease in Females, Journal of Research in Medical Sciences (2012)
5. Sensory Complaints of the Upper Extremities in Multiple Sclerosis: Relative Efficacy of Nortriptyline and Transcutaneous Electrical Nerve Stimulation, Clinical Journal of Pain (2009)
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