{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:49:13Z","timestamp":1781106553267,"version":"3.54.1"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Lower urinary tract symptoms (LUTS) significantly affect quality of life (QoL) of multiple sclerosis (MS) patients, and pharmacotherapy has limited efficacy. We investigated efficacy and safety of the implantable StimRouter neuromodulation system for treating refractory LUTS in MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective, single\u2010center, clinical trial was conducted at the Multiple Sclerosis Center of Lugano, Switzerland, involving MS patients treated with self\u2010administered percutaneous tibial nerve stimulation delivered by StimRouter over 24\u2009weeks. Changes in video\u2010urodynamic parameters as well as LUTS severity were measured by Overactive Bladder Questionnaire (OAB\u2010q), QoL using the Multiple Sclerosis Quality of Life (MSQoL\u201054), and treatment satisfaction using a 1\u201310 visual analogue scale. Adverse events were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 23 MS patients recruited, six had neurogenic detrusor overactivity (NDO), five had detrusor sphincter dyssynergia (DSD), and 12 had both NDO and DSD. Of patients with NDO, median bladder volume at first uninhibited contraction significantly increased from baseline to week 24 (median\u2009=\u2009136\u2009mL, interquartile range [IQR] =\u2009101\u2013244\u2009mL vs. 343\u2009mL, IQR\u2009=\u2009237\u2013391\u2009mL; <jats:italic>\u03b2<\/jats:italic>\u2009=\u2009138.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). No significant changes of urodynamic parameters were found in patients with DSD. OAB\u2010q symptom scores progressively decreased, and OAB\u2010q quality of life scores increased (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.50, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively), whereas MSQoL\u201054 scores did not significantly change (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.24, <jats:italic>p<\/jats:italic>\u2009=\u20090.084) in the overall population. Treatment satisfaction was overall high (median\u2009=\u20098, IQR\u2009=\u20096\u20139). No serious adverse events were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>StimRouter represents a minimally invasive, magnetic resonance imaging\u2010compatible, self\u2010administered neuromodulation device leading to objective and subjective improvements of OAB symptoms and related QoL in MS patients with refractory LUTS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16146","type":"journal-article","created":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T03:52:40Z","timestamp":1700279560000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy and safety of the implantable, magnetic resonance imaging\u2010compatible StimRouter neuromodulation system in the treatment of refractory lower urinary tract symptoms in multiple sclerosis patients"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-4649","authenticated-orcid":false,"given":"Rosaria","family":"Sacco","sequence":"first","affiliation":[{"name":"Department of Neurology, Multiple Sclerosis Center Neurocenter of Southern Switzerland, Regional Hospital (EOC) of Lugano  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Maino","sequence":"additional","affiliation":[{"name":"Anestesiologia Neurocenter of Southern Switzerland, Regional Hospital (EOC) of Lugano  Lugano Switzerland"},{"name":"Faculty of Biomedical Sciences Universit\u00e0 della Svizzera Italiana (USI)  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Koetsier","sequence":"additional","affiliation":[{"name":"Anestesiologia Neurocenter of Southern Switzerland, Regional Hospital (EOC) of Lugano  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-6096","authenticated-orcid":false,"given":"Giulio","family":"Disanto","sequence":"additional","affiliation":[{"name":"Department of Neurology, Multiple Sclerosis Center Neurocenter of Southern Switzerland, Regional Hospital (EOC) of Lugano  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Renard","sequence":"additional","affiliation":[{"name":"Urology Service Ospedale Regionale di Bellinzona e Valli (EOC)  Bellinzona Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Digesu","sequence":"additional","affiliation":[{"name":"Department of Urogynaecology Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7554-0664","authenticated-orcid":false,"given":"Claudio","family":"Gobbi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Multiple Sclerosis Center Neurocenter of Southern Switzerland, Regional Hospital (EOC) of Lugano  Lugano Switzerland"},{"name":"Faculty of Biomedical Sciences Universit\u00e0 della Svizzera Italiana (USI)  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9990-3431","authenticated-orcid":false,"given":"Chiara","family":"Zecca","sequence":"additional","affiliation":[{"name":"Department of Neurology, Multiple Sclerosis Center Neurocenter of Southern Switzerland, Regional Hospital (EOC) of Lugano  Lugano Switzerland"},{"name":"Faculty of Biomedical Sciences Universit\u00e0 della Svizzera Italiana (USI)  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.071"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519894714"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4111\/icu.2016.57.6.377"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2814-6"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511414040"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.09.036"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22559"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.67.2.158"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23124"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.01.078"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-020-00980-5"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T09:53:17Z","timestamp":1710928397000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,17]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/ene.16146"],"URL":"https:\/\/doi.org\/10.1111\/ene.16146","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,17]]},"assertion":[{"value":"2023-06-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16146"}}