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Percutaneous Tibial Nerve Stimulation (PTNS): What You Need To Know

New Treatments for overactive bladder

Millions of women in the United States suffer from overactive bladder (OAB). Symptoms of OAB include a sudden and severe urge to urinate, leaking urine when the urge to urinate is felt, urinating frequently during the day, and waking up multiple times throughout the night to urinate. OAB symptoms can be treated with bladder retraining but sometimes do not respond to conservative treatment and require medications. Unfortunately, some women either do not see improvement in their symptoms with medications or they experience unwanted side effects from the medication. For these women, there are additional treatment options that can help control their OAB symptoms. One of these treatment options is called Percutaneous Tibial Nerve Stimulation, also known as PTNS.


What is PTNS and how does it work?

PTNS is a non-surgical procedure that is done in the office. A very thin needle, similar to an acupuncture needle, is placed above the ankle where a special nerve called the tibial nerve is stimulated, which causes stimulation of the nerves around the bladder leading to the brain. The nerve stimulation leads to decreased urgency and urination. At each session of stimulation, the needle is attached to a small device that sends mild electrical pulses through the tibial nerve. These pulses help block the nerve signals that are causing the bladder to be overactive. 


What does PTNS feel like?

Patients typically say they feel a pulsing, tingling or vibrating sensation around the leg or foot during the procedure. The sensations are never painful and some women even say it feels relaxing! Stimulation is performed for 15-30 minutes at each session.


How long is each treatment and how often do I need treatment?

Each treatment takes 30 minutes. Patients receive weekly treatments for 12 weeks. After the first 12 sessions, women typically only need treatment once a month. However, there are some patients that can go several months between sessions while still maintaining bladder control.


Who can do PTNS?

PTNS is a great option for the majority of patients that have tried and failed OAB medications. It is also a wonderful option for those who are unable to take oral medications due to side effects or those who are looking for a non-surgical treatment option. PTNS is not appropriate for patients who are pregnant or who have certain bleeding disorders. Patients with cardiac pacemakers will need approval from their cardiologist before starting PTNS treatments.


What are the side effects?

The majority of patients do not experience any side effects from the PTNS procedure. In rare cases, women may experience mild tingling, bruising, or bleeding at the needle site. These effects typically resolve quickly without further treatment or follow-up care.


How effective is it? How will I know if it is working?

Most patients will see some improvement in their symptoms within the first six treatments, but it can take up to 12 weeks to see results. Patients typically keep a log of their urinary symptoms so they can track changes and improvements. Small changes over the course of treatment end up making big differences in patients’ lives!


What is the cost?

PTNS treatments are relatively inexpensive compared to some oral medications and surgical procedures. We always recommend patients contact their individual insurance company first for further details and potential costs.

If you suffer from OAB symptoms and have not experienced relief with oral medications, or you have experienced unwanted side effects from OAB medications, please contact The Woman’s Center for Advanced Pelvic Surgery to schedule an appointment to discuss PTNS treatment. We look forward to answering your questions and providing you with the knowledge needed to make informed choices about your healthcare.


Cogentix Medical, 2019.

Urology Care Foundation, 2019

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