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Percutaneous Tibial Nerve Stimulation (PTNS)

Percutaneous Tibial Nerve Stimulation (PTNS)

If conservative treatments such as medication and behavioral therapy have been unsuccessful in treating bladder control problems, then a minimally invasive procedure known as Percutaneous Tibial Nerve Stimulation (PTNS) may prove to be a effective treatment option

Percutaneous Tibial Nerve Stimulation (PTNS) is in the neuro-modulation family of treatments.

Neuro-modulation can be described as a therapeutic medical procedure used to alter nervous system function by electrical stimulation. Electrical nerve stimulation devices can either be surgically implanted or externally placed.

PTNS is the least invasive form of neuromodulation used to treat bladder control problems and has proven track record in the effective treatment of both female and male incontinence problems. Studies have shown that 70-80 % of patients report a significant improvement in their bladder control symptoms.


The PTNS Procedure

Percutaneous Tibial Nerve Stimulation (PTNS) is a minimally invasive procedure where electrical stimulation is delivered using a very fine needle type electrode  (similar to an acupuncture needle). The needle is inserted into the lower leg, slightly above the ankle next to the tibial nerve. To complete the circuit a small pad is stuck to the skin on the bottom of the foot on the same leg. The pads are very similar to the ones that are used to stick on your chest if you have an ECG test. The needle electrode and the pad electrode are then connected to a small hand held device known as a pulse generator.

The sacral plexus is one of the major nerve plexuses in the body. A nerve plexus is the area where the nerves branch out and rejoin. The sacral plexus is located in the back of the pelvis, and provides the nerves for the pelvic area, genitals, and buttocks. One of the functions of the sacral nerve plexus is to control bladder and pelvic floor function It also provides some of the nerves for the legs and feet

The pulse generator delivers an electrical signal that travels along the tibial nerve up to the sacral plexus in the pelvis. By sending small electrical signals along the tibial nerve up to the sacral plexus unwanted signals to and from the bladder that can cause OAB can be dampened down.

The procedure is normally carried out with the patient sitting comfortably in a lounge chair with one leg raised on a stool. The needle electrode is then carefully inserted into the lower leg and the grounding pad attached to the bottom of the foot once the electrode and pad are in place, the pulse generator is activated and the strength of the pulse is gently increased until you can feel a tingling sensation going into the foot. This often causes an involuntary movement of the toes, which is completely normal and harmless. During the stimulation treatment, patients often feel a gentle impulse in the foot. The nerve stimulation is virtually painless and most patients find the experience quite relaxing. Treatment normally lasts for around 30 minutes.

How many PTNS treatment sessions are needed?

Initially it is recommended that 12 treatment sessions are performed on a weekly basis. Improvements in symptoms normally become apparent after 6-8 sessions.

After 12 weeks if the treatment is proving successful then to maintain the improvement achieved by PTNS occasional top up treatments (about once every 3-4 weeks) may be required.


Are there any side effects or pain with PTNS?

PTNS is a very low-risk procedure. Side-effects are minimal and so far the treatment has been very well tolerated.

Percutaneous Tibial Nerve Stimulation is a very safe low risk minimally invasive procedure suitable for many, though patients who have a pacemaker or defibrillator, have a history of excessive bleeding or those who are pregnant or planning to become pregnant during treatment would not be suitable to undergo Percutaneous Tibial Nerve Stimulation.


Getting help

If you wish to make an appointment to seek further advice and or treatment, please contact Mr Ockrim’s secretary.




The information contained within this website has been provided as a general guide and should not be treated as a substitute for the medical advice of your own GP or any other health professional.