Background: This study set out to conduct a thorough review of the effects of electrical tibial nerve stimulation in multiple sclerosis (MS) patients with bowel dysfunction. Methods: Several medical databases were searched comprehensively from inception to September 2023. Studies with available English full texts and results for bowel dysfunction following percutaneous tibial nerve stimulation (PTNS) or transcutaneous tibial nerve stimulation (TTNS) were considered. The publications that were included underwent a comprehensive assessment by two independent reviewers, and pertinent data were retrieved. The quality of the included studies was evaluated using Cochrane guidelines. Results: From a total of 200 studies, only 2 prospective interventional studies were eligible for entering this systematic review with no control arm. A total of 93 patients diagnosed with MS (44 females and 49 males) with a median age of 48.32 years were included. Both studies applied PTNS in 30-minute sessions for a maximum of 12 weeks and reported an overall improvement following PTNS in MS-associated bowel dysfunction. Conclusion: This systematic review demonstrated that PTNS can be an effective way of minimizing fecal incontinence in MS patients. However, due to the highly limited number of available publications on this issue, we cannot generalize these findings to larger populations.

Purpose: Inguinal lymphadenectomy (iLAD) reduces mortality in patients with cN0 penile cancer but yields high complication rates. Thus, its prophylactic role has been questioned and dynamic sentinel node biopsy (DSNB) was introduced to select men who should undergo the procedure. Our aim was to investigate the accuracy of a contemporary DSNB cohort. Methods: We performed a retrospective analysis of ≥T1 or ≥G2 cN0 penile cancer undergoing perioperative DSNB from June 2009 to June 2015 at a tertiary referral center. We excluded men with <18 months follow-up or with local recurrence after primary curative treatment. Complications were graded according to the Clavien-Dindo classification. Results: Thirty-five men underwent DSNB; 85.71% had ≤T2 penile cancer with ≤G2a histology. Per groin detection rate was 80% (scintigraphy being positive bilaterally in 60% and unilaterally in 20.0%). In no cases did DSNB prolong the postoperative course compared to primary surgery. Nine men (n = 15/109 nodes removed) had positive results, 8 of whom underwent iLAD. Among negative DSNB patients, 2 developed nodal penile cancer recurrence; none of them had node biopsy due to inconclusive scintigraphy. At a median follow-up of 42 months (interquartile range 30-78 months), if considering only men with scintigraphy detected inguinal nodes, per-patient sensitivity and specificity were 50% and 80% whereas positive predictive value and negative predictive value were 25% and 92.3%, respectively. Conclusions: Perioperative DSNB is a safe procedure, yielding promising results when performed at a tertiary referral center. Future prospective large studies are needed to investigate how to optimize detection rate and reduce false-negative rates.