Efficacy of Peripheral Lidocaine Application (Neural Therapy) in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients (P3.366)

Objective: Many agents and treatments are used in the treatment of neurogenic detrusor overactivity (NDO) in Multiple Sclerosis (MS) patients, but no study has been conducted on the use of peripheric lidocaine on MS patients. We evaluated the effects of local administration of lidocaine on NDO in Multiple Sclerosis patients. Background: Neural Therapy (NT) is a treatment modality using injections with local anesthetics for diagnosis and therapy with the indications including functional disorders, inflammatory diseases, and acute or chronic pain.. Local anesthetics induce Gq–protein-complex mediated intracellular anti-inflammatory mechanisms, deactivate overactive granulocytes, inhibit the signaling of human N-methyl-D-aspartate receptors, and affect the synthesis and release of inflammatory mediators as eicosanoids, histamine, prostaglandins, and cytokines. Design/Methods: For each patient local anesthetic lidocaine was injected at each session. Sessions were held once a week for five weeks. At each session, Th 10-L1, urogenital segment intradermal injections, Frankhausen and sacral epidural injections were given. The patients had clinical and urodynamic assessment one month before and 3, 9 and 12 months after NT. In addition, Multiple Sclerosis Quality of Life Inventory (MSQL-54) and Bladder Control Scale (BLCS) was performed for patients. Results: Twenty-eight patients were included in the study. The patients’ average age was 31.7±8.1 years. The injection therapy significantly improved volume at first involuntary bladder contraction (FCV), maximal detrusor pression during filling (P det. max.), maximal cystometric bladder capacity (MCC) after 3 months. Also, the MSQL-54 and BLCS scores were improved with treatment. However, these improvements reached a maximum three months after treatment, but from the ninth month a regression was seen in the parameters and after 12 months the findings were seen to be slightly above their basal levels. Conclusions: These results suggest that NDO treatment in MS patients could be an effective treatment which is easy and has very few side effects, and is cost effective. Disclosure: Dr. Tamam has nothing to disclose. Dr. Ozdemir has nothing to disclose. Dr. Gedik has nothing to disclose. Dr. Tamam has nothing to disclose. Dr. Nazlikul has nothing to disclose.