Urology and genitourinary medicine > Percutaneous tibial nerve stimulation

  • Percutaneous tibial nerve stimulation (PTNS) is a non-surgical treatment for overactive bladder (OAB) for symptoms of urinary urgency, frequency or incontinence; in some regions it is also used to treat fecal incontinence.
  • PTNS is used when patients do not want to take, or have had side effects from, drugs, or when other forms of treatment have not worked.
  • PTNS is delivered in the office/clinic setting by the Urgent® PC neuromodulation system, which consists of a stimulator, lead set, needle electrode and an adhesive surface electrode (grounding pad). It is the only device available to deliver this therapy via the tibial nerve.
  • The patient is comfortably seated, with the leg elevated and supported. A small, thin needle electrode is inserted near the tibial nerve at a 60° angle, and a surface electrode (grounding pad) is placed near the arch of the foot. The lead wire is connected to the needle and plugged in to the low-voltage stimulator. The mild stimulation impulse travels along the tibial nerve to the sacral nerve plexus – the nerves in the pelvis that control bladder function.
  • Each treatment lasts for 30 minutes and is relatively painless. Patients describe a sensation of ‘tingling’ or ‘pulsing’. A series of 12 treatments are given, typically once a week. Further maintenance therapy is then tailored to the patients needs.
  • Studies report an improvement in 60–80% of patients, with changes in symptoms typically occurring 6–8 weeks after starting treatments. No serious side effects have been reported to date.