Effect of Transcutaneous tibial nerve stimulation on sexual function in women with multiple sclerosis.

Abstract

Aims: The aim was to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) on sexual function in women with multiple sclerosis (WwMS) reporting overactive bladder symptoms.

Methods: All WwMS who underwent 12 to 24 weeks of TTNS for overactive bladder, and pre- and post-treatment assessment between June 2020 and October 2022 were retrospectively included. The effect of TTNS on sexual dysfunction was assessed by the Female Sexual Function Index (FSFI) global score and subdomains, before and after the stimulation. Other data collected were the Sexual Expectation Assessment in Multiple Sclerosis (SEA-MS-F) score to assess patients' expectations regarding the management of sexual disorders, the Expanded Disability Status Scale (EDSS) score, and the Patient Global Impression of Improvement (PGI-I) to assess patient satisfaction with TTNS regarding overactive bladder symptoms.

Results: Fifty-eight patients were included (mean age 47.4 ± 11.5). According to the FSFI score at the initial assessment, 38 patients (65%) had sexual dysfunction. There was no significant difference in the global FSFI score after a mean of 15 weeks of stimulation (p=0.17) or in the different domains of sexual dysfunction (FSFI sub-scores). A minor improvement in the FSFI total score in the group with a lower EDSS score (<6) was found, with a median difference of 0.95 [0; 3.75] (p=0.04).

Conclusion: TTNS showed no significant improvement in global sexual function or specific domains in WwMS and overactive bladder. Further studies targeting more specifically population interested in a dedicated treatment for sexual dysfunction could be valuable.