Percutaneous Tibial Nerve Stimulation (PTNS) For Overactive Bladder

Percutaneous tibial nerve stimulation, or PTNS, is often a front-line option for patients with overactive bladders that have not responded to medication, lifestyle changes, or conservative measures for their OAB. The tibial nerve, which runs from the upper leg to the groin area, is connected to the sacral nerve, which influences the bladder’s function. By stimulating these nerves, we can minimally invasively manage the many symptoms of overactive bladder.

If you and your urologist decide that PTNS is your best option, the procedure is performed in our office using a small electrical generator connected to a needle. The needle is inserted into the leg in the ankle area, at which point the current is deployed through the needle and into the nerve. No significant pain or discomfort is associated with this procedure; most patients feel a light buzzing in their foot and leg. The procedure takes a few minutes and is performed without anesthesia or sedation. Patients will return to the office once a week for 12 weeks during the initial therapeutic period.

After the 12-week treatment, patients will be asked to return to the office monthly for maintenance procedures. 

Side Effects of PTNS

Because of the minimally invasive nature of PTNS, there are very few, if any, side effects. Once again, patients generally report a buzzing sensation in the leg, which is neither painful nor overly uncomfortable. On the flipside, improvement in symptoms can be significant. Patients also have few, if any, post-procedure limitations. They can get back to everyday life and work almost immediately. 

Considerations of PTNS

The most significant consideration of PTNS is the frequency with which the patient returns to the office for maintenance therapy. Those unable to commit to a monthly visit after their 12-week initial treatment may wish to consider other, more permanent options. While more invasive, these options, like bladder Botox or sacral neuromodulation, represent a lesser long-term commitment with arguably better results. 

The Bottom Line

PTNS may be an excellent overactive bladder treatment option for patients who can commit to regular visits to their urologist for therapy. It is a straightforward procedure with few, if any, significant side effects.