Peroneal Nerve Neuromodulation for Overactive Bladder: A Pilot Study Assessing Efficacy and Safety in Patients with Multiple Sclerosis
DOI:
https://doi.org/10.24915/apuj.257Keywords:
Multiple Sclerosis/complications, Patient Reported Outcome Measures, Peroneal Nerve, Transcutaneous Electric Nerve Stimulation, Urinary Bladder, Overactive/etiology, Urinary Bladder, Overactive/therapyAbstract
Introduction: Overactive bladder (OAB) symptoms are highly prevalent among patients with multiple sclerosis (MS), significantly impairing quality of life. Peroneal nerve neuromodulation (PNM) has emerged as a potential alternative to posterior tibial nerve stimulation for managing refractory OAB symptoms, although no studies to date have directly evaluated its effects in MS patients. We aimed to assess the clinical and urodynamic effects of transcutaneous peroneal nerve neuromodulation in patients with MS and neurogenic OAB.
Methods: This prospective single-center open-label pilot study included 18 patients with MS and OAB symptoms refractory or intolerant to first-line treatments. Participants received weekly transcutaneous PNM for 12 weeks. Outcomes included changes in urgency episodes (OAB-SF), symptom severity and impact in quality of life (ICIQ-OAB), and urodynamic parameters. Data were analyzed using paired statistical tests ( < 0.05).
Results: Statistically significant improvements were observed in urgency-related items of the OAB-SF and ICIQ-OAB questionnaires, reflecting reduced symptom burden and increased bladder control. Urodynamic data revealed a significant increase in maximum cystometric capacity ( = 0.041), with a trend toward improved urgency volume ( = 0.053). One mild adverse event (local skin burn) was reported and resolved spontaneously. No other adverse effects occurred.
Conclusion: Peroneal nerve neuromodulation appears to be a safe and potentially effective intervention for improving urgency and bladder storage capacity in MS patients with OAB. These findings support further investigation in larger, controlled studies with longer follow-up and functional neuroimaging to better understand therapeutic mechanisms and long-term outcomes.
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