Percutaneous Tibial Nerve Stimulation

PTNS for Overactive Bladder

Millions of Americans suffer from overactive bladder, also known as OAB. Some estimate that 1 in 3 American adults experience the symptoms associated with OAB. OAB is a condition in which the bladder contracts inappropriately, causing frequency of urination, urgency of urination, and leakage of urine. This can create potentially embarrassing but, at the very least, bothersome situations. Oftentimes, the exact cause of OAB is not known.

For many, stimulating nerves related to the bladder can produce excellent results. One such potential therapy is known as percutaneous tibial nerve stimulation or PTNS. PTNS stimulates the tibial nerve in the ankle area, connected to the pudendal nerve bundle that controls the bladder. By regularly stimulating this related nerve, many patients experience significantly improved symptoms.

How the Procedure Works

Patients will be scheduled for 12 consecutive weekly appointments at one of our offices in the greater Atlanta area. During each appointment, a small acupuncture-type needle will be placed near the ankle to access the tibial nerve. A low-level electrical signal will be used to stimulate the tibial nerve. Each session lasts approximately 30 minutes. Patients report essentially no pain and a buzzing sensation in the ankle area during the therapy.

Once the initial therapeutic sessions are complete, patients are asked to come into the office once per month for a maintenance treatment, which allows for the continual relief from overactive bladder symptoms.

Considerations and the Side Effects of PTNS

One of the most compelling benefits of PTNS is that it has few if any, side effects. As mentioned above, patients typically feel some buzzing or sensation in the ankle area but no discomfort or pain. To maximize the benefits of this therapy, patients must complete their 12-session course, as an incomplete therapeutic course has been shown to be ineffective. The biggest concern is ongoing therapy, as patients must come into the office once a month for a maintenance procedure indefinitely.

Comparison to Bladder Botox

PTNS is a viable option for patients who do not want the more invasive Botox procedure, which injects Botox into the bladder. Although Botox may provide a longer benefit, it comes with more risk and the potential need for a catheter. In addition, the Botox procedure is usually done in an operating room setting.

Comparison to Sacral Nerve Neuromodulation

Sacral nerve neuromodulation is another treatment for OAB and involves the implantation of a pacemaker-like device that sends signals to the bladder to regulate its function. The benefit of PTNS is that it is less invasive and does not require surgical implantation of the device. However, sacral neuromodulation is considered a permanent solution and can be completed in 1 visit. This may be more desirable to some patients unwilling or unable to come in for regular appointments.

The Bottom Line

PTNS may be a viable option for some patients and has proven beneficial for treating overactive bladder. It is also straightforward and minimally invasive, which adds to its benefits. However, many patients are interested in a semi-permanent solution such as Botox or a permanent solution such as sacral neuromodulation like Axonics or InterStim.

Most importantly, patients should know that Georgia Urology is a leader in treating overactive bladder and utilizes a stepwise pathway to ensure patients get relief from their symptoms. Our practice prides itself on managing OAB patients to improve the quality of life of our patients. We utilize our specific OAB pathway from our patient’s first visit to a successful treatment. We also continue regular checkups to maximize symptom relief and a normal life.