Percutaneous Tibial Nerve Stimulation

Percutaneous Tibial Nerve Stimuation (PTNS) is a low-risk, non-surgical treatment. PTNS works by indirectly providing electrical stimulation to the nerves responsible for bladder and pelvic floor function. During PTNS treatment, the patient’s foot is comfortably elevated and supported. Also during treatment, a slim needle electrode is placed near the nerve at the ankle known as the tibial nerve. A device known as the Urgent PC Stimulator is connected to the electrode and sends mild electrical pulses to the tibial nerve. These impulses travel to the sacral nerve plexus, the group of nerves at the base of the spine responsible for bladder function.

By stimulating these nerves through gentle electrical impulses (called neuromodulation), bladder activity can be changed. Because this change happens gradually, patients receive a series of 12-weekly, 30-minute treatments. After the 12 treatments, when the patient’s response to therapy is assessed, occasional treatments may be needed to sustain symptom improvement.

PTNS is a form of electroacupuncture.

This therapeutic treatment is for patients experiencing overactive bladder (OAB) symptoms of urinary urgency, urinary frequency and/or urge incontinence. PTNS has been approved by regulatory agencies outside the United States to treat fecal incontinence, but has not been approved for this usage in the US at this time. PTNS is generally used after behavior modifications, Kegel exercises and failure of medications.

There are patients who should not be treated with PTNS. These patients are those with pacemakers or implantable defibrillators; patients prone to excessive bleeding; patients with nerve damage that could impact either tibial nerve or pelvic floor function; and patients who are pregnant or planning to become pregnant during the duration of the treatment.