Percutaneous Tibial Nerve Stimulation Therapy

Percutaneous tibial nerve stimulation therapy (PTNS) is used to treat overactive bladder (OAB) and the associated symptoms of frequent urination and incontinence.

Sometimes also referred to as posterior tibial nerve stimulation, PTNS is a significant alternative to using anticholinergic drugs to treat OAB. OAB can be a serious issue for patients who already have other complex issues, for example their balance. The bladder tells the brain to get up in the middle of the night and urinate. The darkness combined with poor eyesight often results in people falling on their way to the bathroom in the middle of the night. Anticholinergic drugs used to treat patients for OAB such as Oxybutynin, Tolterodine, Tamsulosin, Fesoterodine, Solifenacin, and Trospium, can commonly cause dizziness. Therefore, using such drugs on a balance-impaired person to address OAB is not very practical.

While you are seated in a very comfortable chair in our clinic, we will insert a very fine needle electrode on the inside of your leg above the ankle. The actual insertion target is a location near the tibial nerve. A grounding pad is placed on the heel. The medical assistant then slowly turns up the electricity (measured in microvolts) until you feel a tingling and/or there is an involuntary flexing of the toe or the entire foot. The electricity travels along the tibial nerve to the sacral nerve plexus (SNP). The SNP regulates bladder function and responds to the electrical stimulation by telling the brain when the bladder is actually full.

PTNS is a low-risk procedure. The most common side effects with PTNS treatment are temporary and minor, and most often result from the placement of the needle electrode. Potential side effects include minor bleeding, mild pain and skin inflammation.

The procedure generally takes 30-45 minutes with weekly visits for 12 weeks. Many patients often see improvement by week five or six. Depending on the person, additional treatments may take place every three or four weeks.

If you are not already our patient, you will need to have an initial visit with one of our providers first in order to ensure that you are a good candidate for the procedure.