LAUSR

– First, in the statistical analysis section, the authors stated that they had used Student t-test or theMannWhitney U test for variables with or without normal distribution, respectively. Nonetheless, these two tests are used to compare two independent variables. The authors performed a pre-test post-test design rather than a comparison of two independent groups. Therefore theymust useWilcoxon signed rank test or Paired t test. Accordingly, the results of this study are not valid and need to be reanalyzed with correct/ appropriate statistical tests. – Second, anticholinergic drugs, keeping in mind the tolerability and limited effects, have been reported to be the first-line option in the management of detrusor overactivity in MS patients. We are interested in knowing why the authors stopped anticholinergic drug treatment? Were anticholinergic drugs ineffective? The authors should justify and clarify this item. – After reading this article, physicians would like to make a comment on their clinical practice as regards the management of MS patients. From this point of view, this article lacks sufficient data such as residual urine measurement, urinary tract ultrasound results, indwelling/ intermittent catheterization those might be indicative/ suggestive for the management of bladder dysfunction in MS patients. – The authors should justify why they have conducted such a study. What is their hypothesis? They mentioned the difficulty/limitation of lidocaine application in the bladder and then “peripheral administration is not studied” has been highlighted. It's like trying to create an image like the use of the same drug in different ways, but that is not the case. We think that NT has not any similarity with the intravesical administration; as such it's nothing more than “Fishing expedition”. In this respect, one can say that “let's search the effects of lidocaine injection to the nail or bottom of the hair”. – How long training does this kind of unusual/deep injection require? Who performed the injections? Why is there no imaging? There was hematuria in one of the patients. Why did it happen? Hemorrhage during injection? What are the sizes of needles varying from patient to patient? – Although some of the injections might be rationalized with the segmental levels, how can the authors justify/rationalize the other injections to several points? – The authors mention the neural therapy as a very effective treatment. Where are the data? – What are the “alternative” impacts of lidocaine? – Last but not least, this study lacks a sham (control) group; eg, dry needling or injections with other solutions. Therefore this study does not make sense, even if the results are significant without a control group.