Feasibility Study of Transcutaneous Tibial Nerve Stimulation for Urinary Symptoms in People With Multiple Sclerosis
Feasibility Study of Transcutaneous Tibial Nerve Stimulation for Urinary Symptoms in People With Multiple Sclerosis
Neurogenic lower urinary tract dysfunction is common among people with Multiple sclerosis
 with a pooled prevalence of 68.41% using self-report measures and 63.95% using urodynamic
 studies. Transcutaneous Tibial Nerve Stimulation (TTNS) is a non-invasive treatment option to
 manage bladder storage symptoms, however, the potential efficacy of TTNS among people with
 multiple sclerosis is based on a small number of studies with the absence of high-quality
 evidence relating to efficacy, and lack of clarity of the optimal electrical stimulation
 parameters and frequency, duration and number of treatment sessions. The feasibility and
 acceptability of TTNS to manage storage bladder symptoms using Transcutaneous Electrical
 Nerve Stimulation (TENS) needs to be established before proceeding with a definitive
 randomised trial. This study aims to assess whether TTNS is feasible and acceptable as a
 treatment for bladder storage symptoms in people with MS
The investigators will use a single-arm experimental study to explore the feasibility and
 acceptability of TTNS in the treatment of bladder storage symptoms in multiple sclerosis. The
 CONSORT extension for pilot and feasibility studies will be followed to standardise the
 conduct and reporting of the study. The recruitment plan is twofold: 1) Open recruitment for
 people with MS through MS Ireland's communication channels; 2) Recruitment from a convenience
 sample of people with MS who have previously participated in a qualitative study. The
 investigators will assess recruitment/retention rates, the urinary symptoms changes and the
 effect on quality of life using International classification of incontinence questionnaire -
 overactive bladder (ICIQ-OAB), 3-day bladder diary, King's Health Questionnaire and collect
 self-reported data on adherence and adverse events and acceptability of using TTNS.
Inclusion Criteria:

 -  Self-reported diagnosis of any type of Multiple Sclerosis

 -  Male or female

 -  Aged ≥18 years old

 -  Ambulatory

 -  At least one bladder storage related symptom (e.g. urinary frequency, urinary urgency,
 nocturia with or without incontinence).

 Exclusion Criteria:

 -  People with an indwelling urethral catheter or indwelling suprapubic catheter

 -  Urologic disease including bladder malignancy

 -  Diabetic mellitus

 -  Pregnant women or planning to be pregnant during the study time

 -  Recent pelvic related surgery <1 year

 -  Pacemaker or other metallic internal devices

 -  Urinary tract infections (UTIs) during recruitment phase.