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Stimulation of Acupuncture Points in Female Patients With Multiple Sclerosis and Neurogenic Bladder Dysfunction

Not Applicable
Recruiting
Conditions
Neurogenic Bladder Dysfunction
Registration Number
NCT07183683
Lead Sponsor
Charite University, Berlin, Germany
Brief Summary

Electrical vs. manual stimulation: The study compares two types of acupuncture - one using mild electrical currents and one using just manual no-needle techniques in the treatment of urinary bladder disfunction.

The study focuses on women diagnosed with multiple sclerosis (MS) who also have neurogenic bladder dysfunction - a condition where the bladder doesn't work properly due to nerve damage.

Detailed Description

The objective of this study is to evaluate the feasibility, therapeutic effects, and safety of (A) electrical stimulation of acupuncture points (using a TENS device) in addition to routine care, and (B) manual stimulation of acupuncture points (using acupressure) in addition to routine care, compared to (C) routine care alone (control group), in female patients with multiple sclerosis (MS) and neurogenic bladder dysfunction.

Key outcome parameters include symptoms of neurogenic bladder dysfunction assessed using standardized patient-reported outcome measures.

Moreover, a qualitative substudy will be conducted to explore the subjectively perceived effects of the study interventions and the overall feasibility of the study. This will be carried out through semi-structured interviews and analyzed using qualitative research methodology.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
150
Inclusion Criteria
  • Female patients, aged 18-60 years, with relapsing-remitting multiple sclerosis (RRMS) and an Expanded Disability Status Scale (EDSS) score ≤ 6
  • Stable immunomodulatory MS therapy for at least 3 months prior to enrollment
  • Presence of at least 3 out of the following 6 criteria indicative of overactive bladder dysfunction: urgency, daytime urinary frequency >10 times, nocturia >1 time per night, post-void dribbling, incontinence, or delayed initiation of micturition
  • Participants must be willing and cognitively and linguistically capable of adhering to the study protocol, performing the study interventions, and completing the required study documentation
  • Capacity to provide informed consent, and provision of written consent for both written and electronic data collection and participation in the study
Exclusion Criteria
  • Acute MS relapse within the last 3 months prior to individual study entry
  • Planned change in immunomodulatory therapy during the study period
  • Current need for regular self-catheterization (more than twice per week)
  • Clinically relevant post-void residual volume, confirmed by ultrasound (>100 mL or >40% of pre-void volume)
  • Current or past history of bladder cancer
  • Implanted defibrillator or other pacemaker
  • Urogenital causes of bladder dysfunction, such as stress urinary incontinence or bladder prolapse
  • Spinal trauma within 5 years prior to study entry or any other pre-existing central nervous system disorders (e.g., stroke, Parkinson's disease), or history of pelvic, spinal, or bladder surgery
  • Acute urinary tract infection at the time of screening or within the previous 4 weeks
  • Urolithiasis or urogenital tumors within the past 6 months
  • Previous electrical posterior tibial nerve stimulation (TNS), acupuncture, or acupressure in the same anatomical region within 3 months prior to study entry
  • Regular pelvic floor training (more than twice per week) in the past 6 weeks or planned during the study period
  • Planned participation in another interventional clinical trial during the study period
  • Open wounds, edema, or lymphedema in the lower leg that may interfere with local intervention
  • Other serious pre-existing conditions (e.g., active cancer, heart failure, epilepsy, etc.) that contraindicate participation in the study
  • Obesity, defined as BMI > 30
  • Pregnancy or breastfeeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Incontinence Questionnaire Overactive Bladder (ICIQ-OAB)weeks 5 and 10 after the start of the intervention

Bladder function scoring 0-16, higher values mean worse outcome

Secondary Outcome Measures
NameTimeMethod
Incontinence Quality of Life Measure (I-QoL)weeks 5 and 10 after the start of the intervention

Disease-specific quality of life, scoring 1-110 , the higher the values the better

Patient's Global Impression of Change (PGIC)weeks 5 and 10 after the start of the intervention

Subjective improvement of bladder dysfunction since start of the study, onedimenional scale with seven grades ranging from 'very much worse' to 'very much improved'

3-day voiding diaryweeks 5 and 10 after the start of the intervention

Objective voiding parameters, including mean voiding frequency and average fluid intake to urine output ratio, assessing daytime urination frequency

100mm Visual Analogue pain Scale (VAS) for last menstruationat weeks 5 and 10

Pain during the most recent menstruation ranging from 0: no pain to 100: maximum pain

Trial Locations

Locations (1)

Department for integrative medicine and prevention, Institute for social medicine, epidemiology and health economics, Charité university medicine Berlin

🇩🇪

Berlin, State of Berlin, Germany

Department for integrative medicine and prevention, Institute for social medicine, epidemiology and health economics, Charité university medicine Berlin
🇩🇪Berlin, State of Berlin, Germany
Schönberg Mechthild, study nurse
Contact
+49 30 450 529 027
mechthild.schoenberg@charite.de

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