A Randomized Controlled Trial CONTINENCE CARE

J Wound Ostomy Continence Nurs. 2015;42(1):94-99. Published by Lippincott Williams & Wilkins CONTINENCE CARE Transcutaneous Tibial Nerve Stimulation...
Author: Cecilia Pearson
10 downloads 1 Views 338KB Size
J Wound Ostomy Continence Nurs. 2015;42(1):94-99. Published by Lippincott Williams & Wilkins

CONTINENCE CARE

Transcutaneous Tibial Nerve Stimulation in the Treatment of Lower Urinary Tract Symptoms and Its Impact on Health-Related Quality of Life in Patients With Parkinson Disease A Randomized Controlled Trial Maria Carolina Perissinotto  Carlos Arturo Levi D’Ancona Renata Martins Campos  Anelyssa Abreu

■ ABSTRACT

PURPOSE: A randomized controlled trial study was performed to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) and sham TTNS, in patients with Parkinson disease (PD) with lower urinary tract symptoms (LUTS). DESIGN: Randomized controlled trial. SUBJECTS AND SETTINGS: Thirteen patients with a diagnosis of PD and bothersome LUTS were randomly allocated to one of the following groups: Group I: TTNS group (n = 8) and group II: Sham group (n = 5). Both groups attended twice a week during 5 weeks; each session lasted 30 minutes. METHODS: Eight patients received TTNS treatment and 5 subjects allocated to group II were managed with sham surface electrodes that delivered no electrical stimulation. Assessments were performed before and after the treatment; they included a 3-day bladder diary, Overactive Bladder Questionnaire (OAB-V8), and the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICIQ-SF), and urodynamic evaluation. RESULTS: Following 5 weeks of treatment, patients allocated to TTNS demonstrated statistically significant reductions in the number of urgency episodes (P = .004) and reductions in nocturia episodes (P < .01). Participants allocated to active treatment also showed better results after treatment in the OAB-V8 and ICIQ-SF scores (P < .01, respectively). Urodynamic testing revealed that patients in the active treatment group showed improvements in intravesical volume at strong desire to void (P < .05) and volume at urgency (P < .01) when compared to subjects in the sham treatment group.

94 J WOCN ■ January/February 2015



Adélia Lucio



CONCLUSION: These findings suggest that TTNS is effective in the treatment of LUTS in patients with PD, reducing urgency and nocturia episodes and improving urodynamic parameters as well as symptom scores measured by the OAB-V8 and health-related quality-of-life scores measured by the ICIQ-SF. KEY WORDS: lower urinary tract symptoms, neurogenic bladder, Parkinson disease, transcutaneous tibial nerve stimulation

■ Introduction Parkinson disease (PD) is a neurologic disorder caused by neurodegeneration of the nigrostriatal dopaminergic pathway.1 Lower urinary tract symptoms (LUTS) occur in 7% to 70% of patients during the course of the disease that negatively influence health-related quality of life

 Maria Carolina Perissinotto, PhD, Universidade Estadual de Campinas–Unicamp, Department of Urology, Campinas, São Paulo, Brazil.  Carlos Arturo Levi D’Ancona, PhD, Universidade Estadual de Campinas–Unicamp, Department of Urology, Campinas, São Paulo, Brazil.  Adélia Lúcio, PhD, Universidade Estadual de Campinas–Unicamp, Department of Urology, Campinas, São Paulo, Brazil.  Renata Martins Campos, MSN, Universidade Estadual de Campinas– Unicamp, Department of Urology, Campinas, São Paulo, Brazil.  Anelyssa Abreu, PhD, Universidade Estadual de Campinas– Unicamp, Department of Neurology, Campinas, São Paulo, Brazil. Correspondence: Maria Carolina Perissinotto, PhD, Rua Dr. José Inocêncio de Campos, 74. Apt 103-Cambuí, 13024-230, Campinas, São Paulo, Brazil ([email protected] or [email protected]). DOI: 10.1097/WON.0000000000000078

Copyright © 2015 by the Wound, Ostomy and Continence Nurses Society™

Copyright © 2015 Wound, Ostomy and Continence Nurses Society™. Unauthorized reproduction of this article is prohibited.

JWOCN-D-13-00002_LR 94

18/12/14 10:05 PM

J WOCN

■ Volume 42/Number 1

(HRQOL).2,3 Our understanding of the pathophysiology of LUTS in patients with Parkinsonism is not entirely understood,4 but several factors are postulated to contribute the high prevalence of LUTS among PD patients, including neurogenic bladder dysfunction and comorbid conditions such as prostate enlargement in men.4 Several treatments are commonly used for LUTS in patients with PD, such as antimuscarinic drugs, botulinum toxin, or surgical intervention in selected cases, but these treatments are not always well tolerated.5-8 Conservative treatments such as bladder training, pelvic floor muscle training, and transcutaneous tibial nerve stimulation (TTNS) have been proposed as treatment options for LUTS in nonneurogenic population, but evidence of its efficacy among patients with PD is sparse.9-16 The aim of this study was to evaluate the effect of TTNS in the treatment of LUTS in PD patients. Outcome measures included episodes of urgency and urge urinary incontinence, daytime voiding frequency, and nocturia episodes recorded on a 3-day bladder diary. We also measured LUTS, using the Overactive Bladder Version 8 (OAB-V8) questionnaire and HRQOL via the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICQ-SF). Urodynamic testing was used to measure maximum cystometric capacity, bladder wall compliance, maximum amplitude of detrusor activity, maximum flow rate (Qmax), detrusor pressure at maximum flow rate (Pdet @ Qmax), and postvoid residual volume.

■ Methods A randomized controlled trial was conducted at the Urologic and Neurologic Clinic of Universidade Estadual de Campinas (Unicamp), Campinas, Brazil. The study was approved by the Institutional Ethical Committee (protocol number 783/2008), and written consent was given by the participants before the beginning of the treatment. Inclusion criteria were (1) diagnosis of PD based on Unified Parkinson’s Disease Rating Scale (UPDRS) scores17; (2) stable symptoms for 2 months (ie, no change in physical symptoms as tremor, bradykinesia, impaired posture, and balance and rigid muscles determined by patient report); and (3) cognitive ability to complete bladder log, LUTS, and HRQOL instruments. An additional inclusion criterion was presence of at least 2 of the following LUTS: urgency, urgency incontinence, daytime voiding frequency, nocturia (2 or more episodes were considered clinically relevant), or nocturnal enuresis.18 Participants were excluded if they had urinary tract infection (confirmed by laboratory test), had undergone to previous gynecologic surgery, pregnancy, severe cardiopulmonary disease, diabetes mellitus, bladder outlet obstruction with prostatic enlargement (diagnosis by urodynamic evaluation), or cancer. Individuals using antimuscarinic, other medications for the treatment of LUTS, or medication to control PD were permitted to participate if they had been taking the

Perissinotto et al

95

medication for at least 3 months prior to enrollment and if the dosage did not change over the duration of their participation in the study. All patients were being treated for PD. If participants reported any worsening of PD symptoms during data collection, they were evaluated again by the neurologist using the UPDRS. Participants found to have changes in their UPDRS scores were withdrawn from the study.

Study Procedures After eligible patients were identified on the basis of inclusion and exclusion criteria discussed earlier, study procedures were explained and written consent was obtained. Data collection before and after the intervention was performed by a physiotherapist, except for the urodynamic study, which was performed by a physician. Both physiotherapist and physician were blinded to participant group assignment. Patients were taught how to complete a 3-day bladder diary that registered times of diurnal and nocturnal micturition, episodes of urgency, and urinary incontinence. Study participants then completed the OAB-V8 and ICIQ-SF. Urodynamic testing was completed during baseline evaluation; International Continence Society recommendations for good urodynamic practices were followed.19 Filling cystometry and voiding pressure flow studies were performed with the patients in the standing position using a 6F catheter used to measure intravesical pressure and an 8F catheter for intravesical infusion. Abdominal pressure was measured with a rectal balloon filled with approximately 5 ml of water. The bladder was filled with saline solution at room temperature at a rate of 30 ml/min. Variables included volume at first desire to void, volume at strong desire, volume at urgency, maximum cystometric capacity, bladder compliance, detrusor overactivity amplitude, maximum flow rate (Qmax), detrusor pressure at maximum flow rate ([email protected]), and postvoid residual volume. Involuntary detrusor contraction lower than 5 cmH2O were not considered as detrusor overactivity. The diagnosis of benign prostatic obstruction was done using 2 voiding pressure nomograms, Schafer’s linear pressure urethral resistance relationship and the ICS nomogram, adapted from the Abrams/Griffiths normogram.19 After baseline evaluations were completed, participants were randomly allocated, using a computer-generated randomization list, to 1 of the 2 groups TTNS treatment group (GI) or sham group (GII). Patients were blinded to group assignment; that is, they were unaware of which group was the sham group until the end of the study. A Duaplex 961 (Quark, São Paulo, Brazil) stimulator was used to perform TTNS. Transcutaneous tibial nerve stimulation or sham stimulation was administered over a 5-week period; each session lasted 30 minutes. Participants were treated twice weekly, resulting in 10 sessions. All treatment sessions were conducted by the same physiotherapist. Active TTNS treatment was delivered via 2 carbon rubber

Copyright © 2015 Wound, Ostomy and Continence Nurses Society™. Unauthorized reproduction of this article is prohibited.

JWOCN-D-13-00002_LR 95

18/12/14 10:05 PM

96

Perissinotto et al

electrodes. One electrode was placed below the left medial malleolus and the other one was located 5 cm cephalad to the distal electrode. Proper electrode location was confirmed by the presence of great toe plantar flexion during the delivery of a pulse width of 200 μs at a frequency of 10 Hz with stimulus intensity at the patient’s tolerance level. After the appropriate electrode site was confirmed, the stimulation amplitude was reduced to a level just below the somatic sensory threshold.13,20 Subjects allocated to the sham device (group II) were treated in a similar manner with the exception of active electrical stimulation. A pair of carbon rubber electrode was placed as described earlier for GI. The stimulation unit was turned on and the therapist increased the magnitude of the stimulation on the unit, but these manipulations did not deliver electrical simulation to the tibial nerve.

J WOCN

■ January/February 2015

Both questionnaires used in this study were translated and validated for the Portuguese language1,21,22 and were filled out by the patients. The physiotherapist who collected data was allowed to assist subjects when completing this instrument when necessary.

Data Analyses Statistical analyses were performed using Statistical Analysis System for Windows (SAS, Cary, North Carolina) software. Only patients who completed the study were analyzed. Due to the lack of normal distribution of the variables, a nonparametric test, Mann-Whitney U Test, was used to compare baseline measures before and after intervention between the 2 groups. To compare outcomes before and after the intervention in each group, a Wilcoxon test was used. A P value of ≤.05 was considered statistically significant for all tests.

Instruments The OAB-V8 questionnaire21 was used to evaluate LUTS. This instrument is designed to rate how bothered patients are regarding 4 overactive bladder symptoms: urinary frequency, urgency, nocturia, and urgency incontinence. The subjects were considered to have a likely diagnosis of LUTS if their total score was more than 8. This questionnaire is commonly used to assess overactive bladder symptoms, but it has been useful to evaluate patients’ self-perception of the symptoms caused by lower urinary tract dysfunction.21 The ICIQ-SF22 is a self-report questionnaire with 3 items that evaluate the frequency, severity, and impact of urinary incontinence and an 8-item scale assessing the possible causes or situations related to urinary incontinence. The final ICIQ-SF score is the sum of the total scores, ranging from 0 to 21; higher scores indicate a more negative impact on HRQOL.22

■ Results Between June 2011 and June 2012, 96 patients were identified who fulfilled inclusion criteria. Twenty-three agreed to participate in the research and 13 completed the study. Reasons for declining to participate or complete study procedures included inability to attend clinic for treatment twice weekly (n = 16), exclusion based on baseline evaluation (n = 31), not interested in TTNS as a treatment option (n = 17), unwillingness to undergo baseline evaluation procedures (n = 11), and lost to follow-up (n = 7). Figure 1 summarizes screened patients, subjects enrolled in the study, and participants who completed the study. Table 1 summarizes demographic characteristics of the active and sham treatment groups; no statistical differences were found between groups at baseline. In addition, no differences were

FIGURE 1. Flow diagram for study participants including potential patients excluded from participation and participants who withdrew before completing study procedures.

Copyright © 2015 Wound, Ostomy and Continence Nurses Society™. Unauthorized reproduction of this article is prohibited.

JWOCN-D-13-00002_LR 96

18/12/14 10:05 PM

J WOCN

■ Volume 42/Number 1

Perissinotto et al

97

TABLE 1.

Participant Characteristics for Group I (Active TTNS) and Group II (Sham) Data

Group I

Group II

P (Mann-Whitney U Test)

Age

63.5 (51.0-80.0)

57.0 (50.0-68.0)

.2723

Parkinson beginning

11.5 (2.0-21.0)

5.0 (4.0-15.0)

.1410

Parkinson duration

8.5 (1.0-19.0)

2.0 (1.0-12.0)

.1217

UPDRS subscale I

0.0 (0.0-5.0)

2.0 (0.0-3.0)

.2862

UPDRS subscale II

13.0 (5.0-18.0)

11.0 (11.0-20.0)

1.0000

UPDRS subscale III

12.5 (10.0-21.0)

17.0 (18.0-24.0)

.0547

UPDRS subscale IVA

1.0 (0.0-4.0)

0.0 (0.0-3.0)

.5637

UPDRS subscale IVB

0.5 (0.0-3.0)

0.0 (0.0-3.0)

1.0000

LUTS beginning

2.0 (0.7-6.0)

0.5 (0.0-0.2)

.0594

Nocturia pre

4.0 (2.0-6.0)

4.0 (0.0-5.0)

.6101

ICIQ pre

7.0 (0.0-18.0)

0.0 (0.0-21.0)

.8210

OAB-V8 pre

29.0 (11.0-29.0)

18.0 (6.0-27.0)

.0567

VFD pre

102.5 (47.0-150.0)

100.0 (50.0-150.0)

.6516

VSD pre

150.0 (49.0-400.0)

220.0 (70.0-300.0)

.7133

VU pre

200.0 (85.0-500.0)

300.0 (210.0-380.0)

.1186

Residual volume pre

72.5 (56.0-120.0)

43.0 (13.0-98.0)

.1939

Compliance pre

6.7 (−166.6-33.3)

12.6 (4.4-60.0)

.8710

Amplitude pre

28.0 (5.0-109.0)

59.0 (21.0-88.0)

.6079

Pdet max pre

39.5 (4.0-78.0)

43.0 (19.0-56.0)

1.0000

Flux max pre

8.0 (4.0-26.0)

7.0 (7.0-17.0)

.5504

Abbreviations: ICIQ, Incontinence Quality of Life Questionnaire; LUTS, lower urinary tract symptoms; OAB-V8, Overactive Bladder Questionnaire; TTNS, transcutaneous tibial nerve stimulation; UPDRS, Unified Parkinson’s Disease Rating Scale; VFD, volume at first desire to void; VSD, volume at strong desire; VU, volume at urgency.

found when groups were compared based on adherence to biweekly treatment sessions (median for group I = 18.0 vs median for group II = 17.0; P = .56). Following treatment, bladder diary assessment revealed that patients who underwent active TTNS treatment experienced a statistically significant reduction in the number of urgency episodes over a 3-day period (P < .04) (Table 2). Between-group analysis showed that no

TABLE 2.

Lower Urinary Symptoms Before and After Treatmenta Group I Symptoms

Group II

Baseline

10 Weeks

Baseline

10 Weeks

Frequency

6

2

5

5

Urgency

8

1

5

5

Urge urinary incontinence

6

4

3

3

Hesitancy

1

0

2

2

Abbreviation: TTNS, transcutaneous tibial nerve stimulation. aGroup I = active TTNS; GROUP II = sham device.

statistically significant differences were found when the number of episodes of nocturia was compared between the sham group and the active treatment group (P = .88). However, subjects allocated to active TTNS showed a reduction in the number of nocturia episodes (4.0 vs 2.0; P < .01) after 10 treatments, while those managed by the sham device showed no significant differences (Table 3). Significant differences in OAB-V8 scores were found when patients allocated to the active TTNS group were compared at baseline and following treatment (P < .03; Table 4). In contrast, no differences were found when patients allocated to the sham group were compared at baseline and following treatment (P = .508). No differences were found when groups were compared following treatment (P = .10). Similarly, analysis of ICIQ-SF scores revealed statistically significant differences when subjects receiving active TTNS were compared (P < .01), indicating increased HRQOL following treatment. In contrast, no differences were found when posttreatment scores were compared between the 2 groups (P = .9279; Table 4). Urodynamic testing revealed statistically significant differences in the cystometric volume when subjects

Copyright © 2015 Wound, Ostomy and Continence Nurses Society™. Unauthorized reproduction of this article is prohibited.

JWOCN-D-13-00002_LR 97

18/12/14 10:05 PM

98

Perissinotto et al

J WOCN

■ January/February 2015

TABLE 3.

Outcomes From 3-Day Bladder Diary Before and After Treatmenta Group I Symptoms

Nocturia

Group II

Baseline

10 Weeks

Baseline

10 Weeks

P (Mann-Whitney U Test)

4.0 (2.0-6.0)

2.0b (0.0-12.0)

4.4 (0.0-5.0)

4.0 (0.0-5.0)

.82

Analysis indicates no differences between groups after treatment. Group I = active TTNS, group II = sham device. Analysis reveals difference according to time.

a

b

TABLE 4.

Cumulative OAB-V8 and ICIQ-SF Scores Before and After Treatmenta Group I Questionnaire

Group II

Baseline

10 Weeks

Baseline

10 Weeks

P (Mann-Whitney U Test)

OAB-V8

18.0 (6.0-27.0)

16.0b (6.0-25.0)

29 (11.0-33.0)

21.5 (6.0-21.5)

.10

ICIQ- SF

70.0 (0.0-18)

4.0b (0.0-16.0)

0.0 (0.0-21.0)

0.0 (0.0-19.0)

.09

Abbreviations: ICIQ-SF, Incontinence Quality of Life Questionnaire Short Form; OAB-V8, Overactive Bladder Questionnaire. aAnalysis indicates no differences between groups after the treatment. Group I = active TTNS, group II = sham device. bAnalysis reveals difference according to time.

reported a strong desire to void (P < .05) and infused volume when subjects reported urgency (P < .01; Table 5). In contrast, patients undergoing sham treatment showed no differences in any urodynamic measure before and following treatment. No differences were found when groups were compared following the treatment.

■ Discussion Transcutaneous tibial nerve stimulation is a noninvasive technique that has been reported to improve LUTS by

suppressing detrusor overactivity and improving bladder capacity.13,20 In our study, TTNS reduced the number of episodes of urgency and nocturia on 3-day bladder log when compared to baseline values. Subjects allocated to TTNS also had significant improvements in LUTS scores evaluated on the OAB-V8 and HRQOL based on ICIQ-SF scores. Urodynamic testing revealed significant differences in the volume infused volume when strong desire to void and urgency were reported. TTNS also showed significant differences on strong desire to void and urgency domains of urodynamic testing.

TABLE 5.

Urodynamic Variables Before and After Interventiona Group I

Group II

Baseline

10 Weeks

Baseline

10 Weeks

P (Mann-Whitney U Test)

VFD, ml

102.5 (47.0-150.0)

135.0 (70.0- 180.0)

100.0 (50.0- 150.0)

100.0 (70.0- 100.0)

.07

Variables

VSD, ml

150.0 (49.0-400.0)

185.0 (150.0- 300.0)

220.0 (70.0- 300.0)

150.0 (105.0-200.0)

.69

VU, ml

200.0 (85.0-500.0)

285.0b (200.0- 650.0)

300.0 (210.0- 380.0)

200.0 (200.0-280.0)

.96

Max Cyst Cap, ml

260.0 (88.0-500.0)

235.0 (200.0- 650.0)

220.0 (200.0-380.0)

6.7 (−166.6 to 33.3)

8.3 (−55.0 to 66.6)

215.0 (200.0- 380.0) 12.6 (4.4-60.0)

5.0 (−140.0 to 126.0)

.86 .94

28.0 (5.0-109.0)

37.0 (7.0-61.0)

59.0 (21.0-88.0)

53.0 (19.0-88.0)

.43

Qmax, ml/s

8.0 (4.0-26.0)

8.5 (4.0-24.0)

7.0 (7.0-17.0)

9.0 (5.0-24.0)

.65

Pdet Qmax, cmH2O

39.5 (4.0-78.0)

37.0 (7.0-110.0)

43.0 (19.0-56.0)

30.0 (11.0-51.0)

.87

72.5 (56.0-120.0)

36.5 (7.0-161.0)

43.0 (13.0-98.0)

60.5 (13.0-98.0)

.46

Bladder compliance, ml/cmH2O Det Overactivity Ampl, cmH2O

Postvoid Res, ml

b

Abbreviations: VFD, volume at first desire to void; VSD, volume at strong desire; VU, volume at urgency; Max Cyst Cap, maximum cystometric capacity, bladder compliance measured as ml/cm H2O; Det Overactivity Ampl, detrusor overactivity amplitude; Qmax, maximum flow rate; Pdet Qmax, detrusor pressure at maximum flow rate; Postvoid Res, postvoid residual volume in ml; group I, active TTNS; group II, sham device. aAnalysis reveals no difference between groups. bAnalysis reveals difference according to time.

Copyright © 2015 Wound, Ostomy and Continence Nurses Society™. Unauthorized reproduction of this article is prohibited.

JWOCN-D-13-00002_LR 98

18/12/14 10:05 PM

J WOCN

■ Volume 42/Number 1

Previous studies in patients with idiopathic (nonneurogenic) overactive bladder dysfunction have reported encouraging results after a treatment program with TTNS, including significant difference in voiding frequency, frequency of urgency urinary incontinence episodes, reductions in pad weight, and the number of nocturia episodes.10,11,13 However, few studies have evaluated the effects of TTNS in patients with neurogenic bladder dysfunction such as that associated with PD. One previous nonrandomized controlled trial20 conducted in patients with multiple sclerosis submitted to TTNS also found improvements of LUTS and urodynamic parameters. While our findings and those of previous studies of patients with neurogenic bladder dysfunction showed encouraging results after tibial nerve stimulation, the mechanisms underlying its effects on detrusor overactivity and related LUTS are not known.11,20 Transcutaneous tibial nerve stimulation may inhibit detrusor overactivity by depolarizing somatic sacral and lumbar afferent fibers. Afferent stimulation is postulated to provide central inhibition of preganglionic detrusor motor neurons through a direct route in the sacral cord, reestablishing the balance between inhibitory and excitatory impulses that control bladder function.11,13,20 Additional research is needed to determine how PD impacts nervous control of the detrusor muscle, and how TTNS influences patients with PD and detrusor overactivity.23

Limitations Ten out of 23 patients randomized into our study did not complete the study, primarily due to difficulty attending twice weekly sessions. The dropout rate may have influenced study findings. This significant dropout rate also has possible clinical implications; further research should address the possibility of home-based TTNS with less frequent clinic visits. These considerations are especially important for patients with PD who have physical disabilities, rendering travel to an outpatient care center for multiple visits particularly difficult.

■ Conclusion Findings from this study suggest that TTNS improves LUTS in PD. Additional research is needed to reproduce these findings and to further explore potential barriers associated with the need for multiple clinic visits currently required to deliver TTNS.

■ References 1. Campeau L, Soler R, Anderson KE. Bladder dysfunction and parkinsonism: current pathophysiological understanding and management strategies. Curr Urol Rep. 2011;12:396-403. 2. Yeo L, Singh R, Gundeti M, et al. Urinary tract dysfunction in Parkinson’s disease: a review. Int Urol Nephrol. 2012;44:415-424. 3. Araki I, Kitahara M, Oida T, et al. Voiding dysfunction and Parkinson’s disease: urodynamic abnormalities and urinary symptoms. J Urol. 2000;164:1640-1643.

Perissinotto et al

99

4. Sammour ZM, Gomes CM, Barbosa ER, et al. Voiding dysfunction in patients with Parkinson’s disease: impact of neurological impairment and clinical parameters. Neurourol Urodyn. 2009;28:510-515. 5. Madhuvrata P, Cody JD, Ellis G, et al. Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev. 2012;18:1. 6. Basra RK, Wagg A, Chapple C, et al. A review of adherence to drug therapy in patients with overactive bladder. BJU Int. 2008;102:774-779. 7. Chancellor MB, Anderson RU, Boone TB. Pharmacotherapy for neurogenic detrusor overactivity. Am J Phys Med Rehabil. 2006; 85:536-545. 8. Stöhrer M, Blok B, Castro-Diaz D, et al. EAU guidelines on neurogenic lower urinary tract dysfunction. Eur Urol. 2009;56:81-88. 9. Kabay SC, Yucel M, Kabay S. Acute effect of posterior tibial nerve stimulation on neurogenic detrusor overactivity in patients with multiple sclerosis: urodynamic study. Urology. 2008;71(4): 641-645. 10. McClurg D, Ashe RG, Marshall K, et al. Comparison of pelvic floor muscle training, electromyography biofeedback, and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: a randomized pilot study. Neurourol Urodyn. 2006;25:337-348. 11. Kabay SC, Kabay S, Yucel M, et al. Acute urodynamic effects of percutaneous posterior tibial nerve stimulation on neurogenic detrusor overactivity in patients with Parkinson’s disease. Neurourol Urodyn. 2009;28:62-67. 12. Lúcio AC, Campos RM, Perissinotto MC, et al. Pelvic floor muscle training in the treatment of lower urinary tract dysfunction in women with multiple sclerosis. Neurourol Urodyn. 2010;29:1410-1413. 13. Amarenco G, Ismael SS, Even-Schneider A, et al. Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder. J Urol. 2003;169:2210-2215. 14. Vaughan CP, Juncos JL, Burgio KL, et al. Behavioral therapy to treat urinary incontinence in Parkinson disease. Neurology. 2011;76:1631-1634. 15. Monga AK, Tracey MR, Subbaroyan J. A systematic review of clinical studies of electrical stimulation for treatment of lower urinary tract dysfunction. Int Urogynecol J. 2012;23(8):993-1005. 16. Lúcio AC, Perissinotto MCR, D’Ancona CAL, et al. A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life. Clinics. 2011;66:1563-1568. 17. Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society–sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23:2129-2170. 18. Abrams P, Cardozo L, Fall M, et al. The standardization of terminology in lower urinary tract function: report from the standardization subcommittee of the International Continence Society. Urology. 2003;61:37-49. 19. Shafer W, Abrams P, Liao L, et al. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn. 2002;21:261-274. 20. Sèze M, Raibaut P, Gallien P, et al. Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Neurourol Urodyn. 2011;30:306-311. 21. Acquadro C, Kopp Z, Coyne KS, et al. Translating overactive bladder questionnaires in 14 languages. Urology. 2006;67:536-540. 22. Tamanini JT, Dambros M, D’Ancona CA, et al. Validation of the “International Consultation on Incontinence Questionnaire— Short Form” (ICIQ-SF) for Portuguese. Rev Saúde Pública. 2004;38:438-444. 23. Blackett H, Walker R, Wood B. Urinary dysfunction in Parkinson’s disease: a review. Park Relat Disord. 2009;15:81-87.

Copyright © 2015 Wound, Ostomy and Continence Nurses Society™. Unauthorized reproduction of this article is prohibited.

JWOCN-D-13-00002_LR 99

18/12/14 10:05 PM

Suggest Documents