Neurocentre of Southern Switzerland, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland.
Mult Scler. 2011 Dec;17(12):1514-9. doi: 10.1177/1352458511414040. Epub 2011 Jul 14.
Percutaneous tibial nerve stimulation (PTNS) has been proposed as a new, minimally invasive neuromodulation technique to treat lower urinary tract symptoms (LUTS).
To evaluate efficacy, safety and impact on quality of life (QoL) of PTNS on patients with multiple sclerosis (MS) who have LUTS.
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.
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.
PTNS is an effective, safe and well-tolerated treatment for LUTS in patients with MS.
经皮胫神经刺激（PTNS）作为一种新的微创神经调节技术，被提议用于治疗下尿路症状（LUTS）。
评估 PTNS 对伴有 LUTS 的多发性硬化症（MS）患者的疗效、安全性和对生活质量（QoL）的影响。
21 例（5 例男性，16 例女性）对胆碱能药物治疗无反应的 MS 伴 LUTS 患者接受 12 次 PTNS 治疗。采用经过验证的、自我管理的图表和问卷评估 LUTS，测试 LUTS 对患者的主观和客观相关性及其对治疗前后 QoL 的影响；通过经腹超声扫描评估平均排尿后残余尿量。分析采用意向治疗。
日间尿频（从 9 次减少到 6 次，p=0.04）、夜尿（从 3 次减少到 1 次，p=0.002）和平均排尿后残余尿量（从 98±124ml 减少到 43±45ml，p=0.02）均有显著减少。平均排尿量从 182±50ml 增加到 225±50ml（p=0.003）。89%的患者报告治疗满意度为 70%。King's 健康 QoL 问卷的大多数领域的 QoL 均有显著改善（p<0.05）。未报告不良事件。
PTNS 是治疗 MS 患者 LUTS 的一种有效、安全且耐受良好的治疗方法。
