Interest of transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis. Results of an institutional multicenter study@@@Intérêt thérapeutique de la stimulation transcutanée tibiale postérieure dans les troubles mictionnels irritatifs de la sclérose en plaques. Résultats d’un programme de recherche clinique hospitalier multicentrique

Electrostimulation is an established therapeutic option for neurogenic urinary disorders. The aim of this study was to investigate the efficacy of the noninvasive technique of transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with multiple sclerosis (MS) and troublesome symptoms of an overactive bladder (OAB).A multicentric study enrolled 70 MS patients, suffering from OAB for a three-month study period. Intervention: daily sessions of 20 minutes of TPTNS were provided; no change of associated treatments during the study period. The primary outcome measurement was urgency and frequency reported by bladder diary and symptom score performed before the treatment (Day 0, D0) and at D30 and D90. The secondary outcome measurements were continence, symptom score, quality of life, psychosocial burden at DO, D30, and D90, and cystometry at baseline, with and without TPTNS and at D90.Clinical improvement of OAB was found in 82.6% and 83.3% of the patients on D30 and D90, respectively, with significant improvement of primary and secondary outcomes compared to baseline. The initial acute cystometric response to TPTNS was positive in 51.2% of the patients (increase of > 30% of cystometric capacity and/or reflex volume), without correlation with TPTNS clinical efficiency. The procedure was well-tolerated.Chronic TPTNS appears to be effective in the management of severe OAB in MS, without compromising bladder emptying or inducing side effect. Treatment may be effective even in the absence of an acute cystometric effect. Additional works are required to demonstrate long-term efficacy of TPTNS.