Comparison of quality of life and clinical results of posterior tibial nerve stimulation and selective anticholinergic treatment in multiple sclerosis patients with neurogenic bladder in a randomized clinical trial.

Comparison of quality of life and clinical results of Trans Tibilal Nerve Stimulation(TTNS) and drug treatment in patients with MS with neurogenic bladder

A randomized clinical trial that is conducted in two groups, the first group receiving physiotherapy treatment and the second group receiving drug treatment, phase 2-3, will be conducted on each group of 27 people, a total of 54 people, and rand function of Excel software was used for randomization.

Time :1402 and 1403 in Hashminejad and Firozgar hospitals in Tehran, patients with MS will refer to the urologist with a referral letter from a neurologist based on the diagnosis of MS, and Recently, they have at least one of the symptoms of LUTS such as urgent incontinence, urgency and frequency of daily urination or nocturia, and according to the opinion of the urologist, the symptoms of LUTS need to be investigated and treated, they will be included in the study in two groups of drug treatment and TTNS. They will be assigned to each of the study groups by a simple randomization method using a table of random numbers. In one group, we will do (TTNS) method. A positive electrode is placed 10 cm above the negative electrode along the tibial nerve. The parameter settings include the frequency of 10 Hz and the pulse width of 200 milliseconds. The intensity is 1.5 times the intensity of muscle twitching. Patients will undergo 30-minute outpatient treatment sessions once a week for 12 weeks.

MS disease confirmed by a neurologist, which is proven by the urodynamic test of the patient's overactive bladder, and the patient is over 18 years old.

TTNS treated group The group under drug treatment with anticholinergics

Quality of life include Quality Of Life(QOL) questionnaire and clinical results

Patients will be assigned to each of the study groups using a random number table. In this way, at the time of the patient's consultation, the questionnaires, randomly half of them are in the physiotherapy group and the other half of them are in the drug treatment sub-group. The placement of the questionnaire is random and confusing, and the questionnaires and treatment method are all covered with white paper and cannot be distinguished from the content inside at the time of use. Then randomly at the time of visit, an envelope is taken by the doctor, who is unaware of the treatment method, and the method of treatment is determined from it, and the patient also fills the questionnaire inside the same envelope. The patient's name is written on this envelope and the patient fills out the questionnaire again during the next follow-up to check the changes in his condition after the treatment.

The method of blinding is that both the doctor and the patient are unaware of the content of the cards at the time of conducting this research. At the beginning of the study, questionnaire envelopes were printed for the total number of participants, which are all the same, then this questionnaire and the name of the treatment method, which is either physiotherapy or drug treatment, are placed inside each envelope containing the questionnaire separately. And all this After closing, the envelopes are randomly placed together and the doctor gives each patient an envelope, so both the doctor and the patient are unaware of the treatment method.

All the data including the initial history and all the questionnaires before and after the treatment can be published

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