Urology & Urogynecology 17 mins

Percutaneous Tibial Nerve Stimulation for Overactive Bladder

Written By Laborie

Key Takeaways

PTNS offers a non-drug, non-surgical treatment option for overactive bladder symptoms.
PTNS helps reduce urinary urgency, frequency, and urge incontinence by stimulating bladder-control nerves.
PTNS can be effective even when behavioral therapies or medications have not provided sufficient relief.

Do you suffer from Overactive Bladder (OAB)?

Is it time for you to get Urgent PC PTNS Therapy for your overactive bladder? Take a minute to read the following statements:

I’m tired of dealing with my OAB symptoms of urgency, frequency and/or urge incontinence
I’ve tried behavioral therapy, pelvic floor exercises and drugs but they haven’t provided enough relief
The side effects from drugs are too bothersome for me
I am unable to take medications to treat my OAB
I don’t want to have surgery for my OAB symptoms

If any of these statements apply to you, then ask your healthcare provider if you could be a potential candidate for Urgent PC PTNS Therapy.

Don’t let urinary incontinence control your life. Percutaneous Tibial Nerve Stimulation or PTNS is a periodic, in-office therapy for long-term relief of overactive bladder. It works in men and women, and usually works, even if other treatments have failed.

PTNS therapy is for the type of incontinence called overactive bladder

A type of urinary incontinence, called overactive bladder (OAB) affects over 42 million patients in the US or 16% of adult men and women, negatively impacting their daily routines, relationships and quality of life.¹The symptoms of OAB include:

Urinary Frequency: Urinating more than 8 times during the day or more than 2 times per night (also called Nocturia).
Urinary Urgency: A sudden, intense urge to urinate.
Urge Incontinence: A sudden and unexpected loss of urine.

Percutaneous Tibial Nerve Stimulation is a proven therapy for overactive bladder.

What causes OAB?

Bladder function is a complex interaction between bladder, brain, spinal cord and peripheral nerves. With OAB, this coordination does not work as it should. Instead, bladder nerves continually send signals to the brain that the bladder should be emptied even when it is not full.

PTNS for OAB

Your healthcare provider may take a medical history, test your bladder function or ask you to track your bathroom visits and accidents in a voiding diary. If you receive an OAB diagnosis, your doctor will work with you on a personal treatment plan. Established guidelines for the treatment of OAB include behavioral, drug, and advanced therapies including Percutaneous Tibial Nerve Stimulation therapy for Overactive Bladder.

What is PTNS therapy?

PTNS stands for percutaneous tibial nerve stimulation.
Percutaneous means that therapy is delivered through a needle placed in the skin near your ankle.
The Tibial nerve runs the entire length of your leg.
PTNS uses gentle stimulation, also sometimes referred to as neuromodulation, to affect the nerves responsible for bladder control.

How does PTNS Therapy for OAB work?

This Percutaneous Tibial Nerve Stimulation therapy is a gentle and gradual way of modifying the OAB signals.

During treatment, mild electrical impulses:

Enter through an acupuncture-type needle placed near the ankle
Travel up the tibial nerve in the leg
Reach nerves responsible for bladder control

During the 30-minute therapy session, patients are seated comfortably with their treatment leg raised. Many use this time to rest, read or view their phone.

Why Consider Percutaneous Tibial Nerve Stimulation for Overactive Bladder Therapy?

Studies show that most patients can achieve long-lasting relief of their symptoms. After PTNS, most patients go to the bathroom less and have fewer accidents. ^1-4

Proven Effective:

Over 50 clinical studies in peer-reviewed medical journals demonstrates that Percutaneous Tibial Nerve Stimulation is effective with consistent results.

Up to 80% patient response in men and women^5-12
Reduces frequency, incontinence episodes, nighttime voids and urgency ⁸
Superior to leading drugs with statistically significant reductions in OAB symptoms ^4,7
At 3 years follow-up, all reported quality of life measures remained markedly improved with about one treatment a month⁸

Proven Safe: PTNS treatment side effects

Percutaneous Tibial Nerve Stimulation for Overactive Bladder has been used in over a million treatments since 2005. PTNS is extremely low-risk and comfortable for most patients. The most common PTNS treatment side effects are temporary and include mild pain and inflammation at or near the stimulation site. No serious adverse events with Percutaneous Tibial Nerve Stimulation therapy have been reported.

Patient Preferred: PTNS for OAB symptoms

Percutaneous Tibial Nerve Stimulation is the first choice for patients who didn’t respond to conservative and drug therapies.⁹ In a study, 98% of patients were willing to try PTNS.⁹

Percutaneous Tibial Nerve Stimulation candidates include those who are:

Too old and/or frail for other therapies
Suffering intolerable side-effects from other therapies
Experiencing insufficient response to drugs
Already receiving BOTOX® injections for overactive bladder
Unwilling to perform self-catheterization
Who want a non-drug, non-surgical option

What do patients say PTNS Therapy feels like?

“Sometimes it’s a numbed feeling and other times a pulsing or vibrating or a simple, single twitch of a toe.” – Judith*

“I usually feel tingling in my toes and the bottom of my foot during treatment. It’s very comfortable and relaxing.” – Ann*

Percutaneous Tibial Nerve Stimulation Therapy schedule

30-minute in-office treatments during which you can read, play games or catch up on email.
12 weekly sessions to determine your ideal response. Most patients can expect to see some improvements by about 6 treatments, but it can take up to 12 weeks to see results.
This is followed by periodic maintenance sessions for long-term relief.

Why will I need PTNS maintenance therapy?

There is currently no cure for OAB, and all therapies are ongoing. After the initial 12 sessions, most patients will need a Percutaneous Tibial Nerve Stimulation treatment once a month, but some patients can go months between sessions.
You can schedule your maintenance PTNS therapy around your schedule so you can continue enjoying the freedom of your improved bladder control.

Is it Time for Percutaneous Tibial Nerve Stimulation Therapy?

PTNS therapy for OAB could be right for you if you are or have:

Tired of dealing with my OAB symptoms of urgency, frequency and/or urge incontinence
Tried behavioral therapy, pelvic floor exercises and drugs but they haven’t provided enough relief
Found the side effects from drugs are too bothersome
Unable to take medications to treat OAB
Don’t want to have surgery for OAB symptoms

Talk to your healthcare provider about PTNS Therapy

Your provider will be able to provide insight on what goals are realistic given your age and other health factors. What would it take for you to consider Percutaneous Tibial Nerve Stimulation therapy a success?

Going to the bathroom less often
Less severe urgency
Leaking less urine
Sleeping through the night
Less urinary accidents
Less incontinence pads or underwear
Sitting through an entire movie
More warning time to get to the bathroom
Dinner out without having to use the bathroom
A car trip without stopping at every rest stop

Percutaneous Tibial Nerve Stimulation Therapy is a non-drug, office-based treatment for OAB and associated symptoms of urgency, frequency and urge incontinence.

Ask your provider to learn more.

References

1. Stewart WF, et al. (2003). Prevalence and burden of overactive bladder in the United States. World J Urol, 20, 327-336.
2. MacDiarmid, S.A., & Staskin, D.R. (2009). Percutaneous tibial nerve stimulation (PTNS): a literature-based assessment. Current Bladder Dysfunction Reports, 4, 29–33.
3. Leong, F., McLennan, M.T., Barr, S.A., & Steele, A.C. (2011). Posterior tibial nerve stimulation in patients who have failed anticholinergic therapy: efficacy and time to response. Female Pelvic Med Reconstr Surg 17(2), 74–75.
4. Peters, K.M., MacDiarmid, S.A., Wooldridge, L.S., Leong, F.C., Shobeiri, S.A., Rovner, E.S., et al. (2009). Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the OAB innovative therapy trial. J Urol, 182, 1055–1061.
5. Peters, K., Carrico, D. (2013). Clinical insights into percutaneous tibial nerve stimulation (PTNS) versus sham therapy for the treatment of overactive bladder syndrome (OAB): secondary analysis of the SUmiT Trial. Poster
6. Peters, K.M., Carrico, D.J., Perez-Marrero, R.A., Khan, A.U., Wooldridge, L.S., Davis, G.L., et al. (2010). Randomized trial of percutaneous tibial nerve stimulation versus sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT Trial. J Urol, 183, 1438–43.
7. Vecchioli-Scaldazza, C., Morosetti, C., Beouz, A., Giannubilo, W., Ferrara, V. (2013). Solifenacin succinate versus percutaneous tibial nerve stimulation in women with overactive bladder syndrome: results of a randomized controlled crossover study. Gynecol Obstet Invest, 75(4), 230–4.
8. Peters, K.M., Carrico, D.J., Wooldridge, L.S., Miller, C.J. & MacDiarmid, S.A. (2013). Percutaneous tibial nerve stimulation (PTNS) for the long-term treatment of overactive bladder: three-year results of the STEP Study. J Urol, 189(6), 2194–2201.
9. Hashim, H., Beusterien, K., Bridges, J.G., Amos, K. & Cardozo, L. (2015). Patient preferences for treating refractory overactive bladder in the UK. Int Urol Nephrol. Sept. 7 [Epub ahead of print].
10. Finazzi-Agrò, E., Petta, F., Sciobica, F., Pasqualetti, P., Musco, S., & Bove, P. (2010). Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, double-blind, placebo-controlled trial. J Urol, 184, 2001–06.
11. MacDiarmid, S.A., & Staskin, D.R. (2009). Percutaneous tibial nerve stimulation (PTNS): a literature-based assessment. Curr Bld Dysf Rept, 4, 29–33.
12. Burton, C., Sajia, A., & Latthe, P.M. (2012). Effectiveness of percutaneous posterior tibial nerve stimulation for overactive bladder: a systemic review and meta-analysis. Neurourol Urodyn, 31(8), 1206–16.

* Quote from actual patient. Results may vary, not all patients experience treatment the same way.

Written By

Laborie Medical Technologies

Headquartered in Portsmouth, New Hampshire, Laborie is a global medical technology company focused on Urology, Urogynecology, Gastroenterology, Maternal & Child Health. We manufacture and deliver high-quality, high-impact diagnostic and therapeutic products that help clinicians and hospitals preserve and restore patient dignity. Clinicians and hospitals look to us as the market-leading experts in our business segments, and we support our products with a world-class clinical education & information program. Laborie is a portfolio company of Patricia Industries. For more information visit  www.laborie.com.

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