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

Guitynavard, Fatemeh; Mirmosayyeb, Omid; Razavi, Emami Razavi Vs; Hosseini, Maryam; Hosseinabadi, Ali Mahdi; Ghajarzadeh, Mahsa; Azadvari, Mohaddeseh

doi:10.1016/j.msard.2021.103392

Cited by 10 publications

(13 citation statements)

References 22 publications

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“…Screening the titles and abstracts, left us with 76 studies which were selected for full‐text screening. Finally, 20 SRs met all the inclusion criteria and entered the study 16–35 . The PRISMA flow diagram of the literature search and results is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…From a total of 20 SRs, 13 of them conducted meta‐analysis 16,17,19,20,23,24,27,29,31–35 . China was the leading origin of publication with five studies 16,31–34 .…”

Section: Resultsmentioning

confidence: 99%

“…China was the leading origin of publication with five studies 16,31–34 . After that, Iran 23,24,29 and the United Kingdom 19,20,30 both had three publications.…”

Section: Resultsmentioning

confidence: 99%

“…22 NLUTD was a prominent diagnosis among the studies. 16,19,22,24,27 In addition, several studies investigated the effects of PPTNS on a specific neurological pathology; multiple sclerosis (MS)-induced LUTD was the subject of three SRs, 24,29 and one study included studies regarding TPTNS effects on the QoL in Parkinson's disease. 16 Most of the included studies reported an overall improvement in LUTD following PPTNS, although admitting that these results were derived from moderate to lowquality evidence.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Effects of posterior tibial nerve stimulation (PTNS) on lower urinary tract dysfunction: An umbrella review

Tahmasbi,

Salehi‐Pourmehr,

Naseri

et al. 2023

Neurourology and Urodynamics

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BackgroundLower urinary tract dysfunction (LUTD) is a common, troublesome condition that often negatively affects patients' quality of life. Current literature has long been interested in how posterior tibial nerve stimulation (PTNS) can affect this condition.AimTo extensively and systematically explore how PTNS affects LUTD based on the most recent systematic reviews.MethodsA systematic search was conducted in PubMed, Scopus, Web of Science, and Embase according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. All the systematic reviews, with or without meta‐analysis that assessed the effects of PTNS on LUTD were retrieved. The quality of the included studies was assessed using the Joanna Briggs Institute tool, and analysis was conducted using the Comprehensive Meta‐Analysis version 3 tool.ResultsFrom a total of 3077 citations, 20 systematic reviews entered this study, and 13 of them included meta‐analysis. The population of studies varied vastly, for instance, some studies included only children or women while other focused on a specific pathology like multiple sclerosis‐induced neurogenic LUTD. The majority of included studies reported an overall improvement in LUTD following percutaneous PTNS, although admitting that these results were derived from moderate to low‐quality evidence.ConclusionThe findings of this thorough umbrella review showed that the positive benefits of PTNS in treating LUTD are currently supported by low‐quality evidence, and it is crucial to interpret them with great care.

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Section: Resultsmentioning

confidence: 99%

“…From a total of 20 SRs, 13 of them conducted meta‐analysis 16,17,19,20,23,24,27,29,31–35 . China was the leading origin of publication with five studies 16,31–34 .…”

Section: Resultsmentioning

confidence: 99%

“…China was the leading origin of publication with five studies 16,31–34 . After that, Iran 23,24,29 and the United Kingdom 19,20,30 both had three publications.…”

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Effects of posterior tibial nerve stimulation (PTNS) on lower urinary tract dysfunction: An umbrella review

Tahmasbi,

Salehi‐Pourmehr,

Naseri

et al. 2023

Neurourology and Urodynamics

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“…6 Currently, specific and validated questionnaires have been widely used in neurourology, focusing on lower urinary tract symptoms (LUTS) and on their impact on QoL. 7 Percutaneous tibial nerve stimulation (PTNS) is an effective neuromodulatory technique widely used as a third-line 8 treatment for MS patients experiencing LUTS; [9][10][11][12][13] however, to our knowledge, controlled studies are still not available. The aim of this study was to evaluate the efficacy of PTNS in the treatment of MS patients with NDO unresponsive to pharmacological and behavioural therapies.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous tibial nerve stimulation in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients: a historically controlled study

Carilli

Pacini

Serati

et al. 2023

Therapeutic Advances in Urology

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Background: Percutaneous tibial nerve stimulation (PTNS) is widely used in the treatment of neurogenic detrusor overactivity (NDO) in multiple sclerosis (MS); however, controlled studies are still lacking. Objective: To assess effectiveness of PTNS in MS patients with NDO unresponsive to pharmacological and behavioural therapies. Methods: MS patients with NDO were enrolled. Inclusion criteria were NDO not responding to pharmacological and behavioural therapies. Exclusion criteria were the presence of relevant comorbidities and urinary tract infections. Patients were evaluated using 3-day bladder diaries and validated questionnaires at baseline, after 4 weeks of educational therapy and after 12 PTNS sessions. The primary outcome measure was the percentage of patients considered responders after the behavioural therapy and after the PTNS in a historical controlled fashion (definition of ‘responder’ was reduction ⩾50% of urgency episodes). Results: A total of 33 patients (26 women, 7 men) were enrolled. Two patients dropped out for reasons not related to the protocol. Two out of 31 patients (6.5%) and 21/29 (72.4%) were considered responders at visits 1 and 2, respectively. In PTNS responders, a statistically significant improvement in both bladder diary results and standardized questionnaire scores was recorded, compared with that obtained with behavioural therapy alone. No serious adverse events were reported. Conclusion: This historically controlled study suggests that PTNS may be effective in improving NDO in MS patients.

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A Prospective Observational Study of Posterior Tibial Nerve Stimulation in Multiple Sclerosis

Ippolito,

Palanjian,

Mao-Draayer

et al. 2024

Int Urogynecol J

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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

Cited by 10 publications

References 22 publications

Effects of posterior tibial nerve stimulation (PTNS) on lower urinary tract dysfunction: An umbrella review

Effects of posterior tibial nerve stimulation (PTNS) on lower urinary tract dysfunction: An umbrella review

Percutaneous tibial nerve stimulation in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients: a historically controlled study

A Prospective Observational Study of Posterior Tibial Nerve Stimulation in Multiple Sclerosis

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