Percutaneous tibial nerve stimulation, PTNS

What is Percutaneous tibial nerve stimulation?

Percutaneous tibial nerve stimulation (PTNS) is a minimally invasive in-office procedure that is used to treat overactive bladder for men and women. This treatment option requires 12 consecutive treatments in order for patients to experience optimum results. It can also be prescribed as maintenance after the first series of treatments are complete.

Overactive Bladder

Overactive bladder (OAB) is a common urologic condition that affects over 30 million Americans. Symptoms associated with OAB can include a sudden, urgent need to urinate, frequent urination and urinary incontinence (urge incontinence). There are several treatment options for overactive bladder including:

Behavior modification, bladder retraining, lifestyle changes
Lifestyle changes
Medications
Botox injected into the bladder
Percutaneous tibial nerve stimulation (PTNS)
Pelvic floor physical therapy
Sacral nerve stimulation (implanted InterStim device)

What is percutaneous tibial nerve stimulation?

Percutaneous tibial nerve stimulation is a minimally invasive, drug-free option for treating the symptoms of overactive bladder. The goal of this procedure is to modify signals from the sacral nerves (S3) to help stabilize bladder function, and allow patients to regain bladder control. The sacral nerves are connected to the bladder, and extend down the leg to the tibial nerve near the ankle.

The PTNS procedure involves placing a thin, needle electrode into the tibial nerve near the ankle. Over the course of 30 minutes, this electrode delivers mild impulses into the nerve. For optimal results, PTNS is given once a week for 12 consecutive weeks. After the initial treatments, PTNS is performed monthly to ensure long-term benefits.

What to expect when having PTNS

At each visit, the patient will be brought into a patient room where they can sit comfortably. Their leg will then be extended and elevated on a pillow. When treatment begins, a very thin needle electrode will be inserted into a nerve in the ankle. The electrode is connected to a small hand-held stimulator that controls the impulses that pass through the needle into the nerve. During the stimulation process, patients may experience a tingling or pulsating sensation that should not be uncomfortable or painful. This stimulation process is called neuromodulation.

Percutaneous tibial nerve stimulation risks

Because PTNS is a minimally-invasive procedure, there are few side effects. However, patients may experience:

Mild discomfort or pain at the insertion site – including throbbing pain.
Redness, inflammation or irritation at or near the insertion site.
Possible bruising at the insertion site.
Toe numbness.
Stomach ache.

Not every patient is a candidate for PTNS. This procedure is not recommended for the following individuals:

Patients with bleeding disorder, or who are taking blood thinners.
Pregnant women, or those who may become pregnant during the course of treatment.
Patients with pacemakers or defibrillators.
Nerve damage or disorders – If patients have diabetic neuropathy or other nerve disorders, they should discuss PTNS with their physician before starting treatment.

If you have overactive bladder symptoms and would like to discuss PTNS, contact Urology Austin to schedule an appointment with one of our urologists.

Dr. Rachel Sosland, Board Certified Urologist at Urology Austin, is interviewed by KXAN TV about common urological conditions that effect millions of Americans. Dr. Sosland discusses the symptoms and treatment options for urinary incontinence (stress incontinence), overactive bladder and urinary retention. She also talks about third-line therapies such as botox injections, InterStim Sacral Nerve Stimulation, and Percutaneous Tibial Nerve Stimulation (PTNS).