Percutaneous Tibial Nerve Stimulation 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.

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*

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.

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