Management strategies for neurogenic lower urinary tract dysfunction: a qualitative study of the experiences of people with multiple sclerosis and healthcare professionals

Dandan, Hawra B. Al; Galvin, Rose; McClurg, Doreen; Coote, Susan; Robinson, Katie

doi:10.1080/09638288.2021.1887378

Cited by 7 publications

(7 citation statements)

References 86 publications

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“…Several studies have been conducted to investigate the negative impact of LUTD on daily living activities and health-related QOL in people with MS [6]. Urine symptoms in MS have a detrimental influence on QOL as they restrict involvement in daily activities, negatively influence emotional status, social roles, and employment, and can lead to an increased risk of falls in older MS patients [7]. The QOL of MS is influenced not only by urinary symptoms and other health-related complications, but other factors such as social life, physical activity, and environment can play a critical role.…”

Section: Discussionmentioning

confidence: 99%

“…The primary progressive form (present in 15% of patients) is characterized by gradual and progressive neurological symptoms with few flares [5]. The most prevalent autonomic disruption in persons with MS is neurogenic lower urinary tract dysfunction (LUTD), which continues to be a clinical challenge to treat, resulting in significant yearly healthcare expenses and causing significant handicaps in afflicted persons that affect many elements of daily living [2,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia—A Cross-Sectional Study

Alghamdi,

Amer,

Aldosari

et al. 2023

Healthcare

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Background: Lower urinary tract dysfunction (LUTD) is caused by neurogenic factors that could lead to permanent injury in affected patients, and therefore result in substantial annual healthcare expenses. LUTD is very prevalent in multiple sclerosis (MS) patients and has a drastic impact on their quality of life (QOL). This study aimed to assess the effect of LUTD on the QOL of Saudi MS patients. Methods: A cross-sectional study was carried out in Saudi Arabia using a self-administered questionnaire that included the World Health Organization Quality of Life (WHOQOL-BREF) and LURN Symptom Index (LURN SI-29). Data were analyzed and presented as frequencies and percentages. Results: There were 428 patients who participated in this study; 270 were females and 158 were males. Most of the patients received a low score in all sections of the LURN part of the questionnaire. The highest scores (urgent need to urinate and excessive urination at night) were recorded in the urgency domain (47.20 ± 36.88) rather than the nocturia domain (44.74 ± 32.91). Meanwhile, the lowest score (complete control of bladder) was recorded in the incontinence domain (22.80 ± 26.80). For the WHOQOL-BREF score, the highest score (more social stability) was in the social domain (65.07 ± 21.16 for females, 60.41 ± 21.54 for males), and the lowest score (less psychological stability) was in the psychological domain (46.36 ± 9.84 for females, 46.20 ± 10.03 for males). However, there was no significant association between the four domains of the WHOQOL-BREF and the gender of the MS patients. Conclusions: LUTD is significantly associated with a lowered quality of life. Therefore, patients are recommended to consult with and be evaluated by appropriately experienced healthcare providers and clinicians. This ensures that the patients receive the best advice, accurate and effective treatment, and long-term analysis that can lead to an improvement in their quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia—A Cross-Sectional Study

Alghamdi,

Amer,

Aldosari

et al. 2023

Healthcare

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“…Recruitment to the study commenced in October 11th 2021 and follow-up was completed in March 12th 2021. Recruitment was conducted using two methods: 1) Open recruitment for PwMS through MS Irelands communication channels from October 2020 to January 2021; 2) a convenience sample of PwMS from existing participants who have already participated in our previous qualitative study (12). Eligible participants were provided with a link to a survey using Qualtrics Survey Software Platform to read and sign the informed consent form, complete demographic data including the Patient Determined Disease Steps (PDDS) (18) and baseline outcome measures.…”

Section: Identi Cation and Consentmentioning

confidence: 99%

“…In PwMS, urinary symptoms negatively impacts on emotional wellbeing, physical health, employment opportunities, recreational activities, and social life (7)(8)(9)(10)(11). Qualitative research has similarly found that urinary symptoms are very troublesome for PwMS and that many PwMS continue to suffer in silence, unsure or unaware of what services to access and they frequently experience gaps in health service provision (12). Neuromodulation, a peripheral electrical nerve stimulation used to modulate function of central nervous system (CNS), is a conservative treatment option for urinary symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Tibial nerve stimulation (TNS) is a form of non-surgical neuromodulation (4) and its main function is to inhibit bladder contraction which in turn reduces high bladder pressure and therefore prevents urinary incontinence (14). PwMS and healthcare providers have reported they are open to the use of transcutaneous tibial nerve stimulation (TTNS) for urinary symptoms (12). A systematic review (15) on the e cacy of TNS among people with MS identi ed seven studies: 6 focused on percutaneous tibial nerve stimulation (PTNS) and one focused on TTNS.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and Acceptability of Transcutaneous Tibial Nerve Stimulation for the Treatment of Bladder Storage Symptoms Among People with Multiple Sclerosis.

Dandan¹,

Galvin²,

Robinson³

et al. 2021

Preprint

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Background: Neurogenic lower urinary tract dysfunction is an abnormality in the presence of underlying neurologic disease. A recent systematic review and meta-analysis demonstrated that storage phase symptoms are the predominant symptoms among people with multiple sclerosis (PwMS). Transcutaneous tibial nerve stimulation (TTNS) is a non-invasive treatment for bladder storage symptoms; however, the potential efficacy of stimulation among PwMS is based on a small number of studies with the absence of high-quality evidence. The aim of this study was to evaluate the feasibility, acceptability, and safety of TTNS in PwMS using an affordable transcutaneous electrical nerve stimulation (TENS) unit.Methods: A total of 23 participants with MS enrolled in the study. The primary outcomes included recruitment/retention rate, completion of the outcomes and the intervention, adherence to the protocol, adverse events, and acceptability of the intervention. The primary outcomes were assessed using diaries and satisfaction questionnaire. The secondary outcomes included changes in urinary symptoms and quality of life assessed using a set of validated outcome measures including 3- day bladder diary, PPIUS, ICIQ-OAB, and KHQ at baseline and post-intervention. Results: 20 participants completed the study. Three participants (13.04%) withdrew. All 20 participants completed the 6-week intervention and all the outcome measures (100%), with no reported adverse events. Participants were satisfied and found the unit acceptable. 3-day bladder diary showed changes in urinary frequency from a daily median of 10 times to 8 times and daily median urgency changed from 6 times at baseline to 2 times post-intervention. PPIUS showed changes in daily median sever urgency from 3 points (IQR=4) to 1 point (IQR=1) post-intervention. ICIQ-OAB total scores changed from 8 points (IQR=2.25) to 4 points (IQR=2.5) post-intervention. Median and mean scores of KHQ showed a clinical meaningful change of QoL in part-two and part-three of the questionnaire. Conclusions: TTNS is feasible, safe, and acceptable for PwMS. Changes of urinary symptoms scores and QoL post-intervention suggested improvements. Future implications need to consider the treatment protocol including frequency of treatment sessions, duration of treatment, and the electrical stimulation parameters as well as the outcome measures followed in the current study for the implementation of the future pilot RCT.Trial registration: ClinicalTrials.gov (NCT04528784). Registered 27 August 2020, https://register.clinicaltrials.gov/prs/app/action/LoginUser?ts=1&cx=-jg9qo4

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Psychosocial Factors in Neurogenic Lower Urinary Tract Dysfunction: Implications for Multidisciplinary Care

Sebesta

Connors

Rourke

et al. 2022

Curr Bladder Dysfunct Rep

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Management strategies for neurogenic lower urinary tract dysfunction: a qualitative study of the experiences of people with multiple sclerosis and healthcare professionals

Cited by 7 publications

References 86 publications

Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia—A Cross-Sectional Study

Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia—A Cross-Sectional Study

Feasibility and Acceptability of Transcutaneous Tibial Nerve Stimulation for the Treatment of Bladder Storage Symptoms Among People with Multiple Sclerosis.

Psychosocial Factors in Neurogenic Lower Urinary Tract Dysfunction: Implications for Multidisciplinary Care

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