Percutaneous tibial nerve stimulation (PTNS), also known as Urgent PC, is a virtually painless and nonsurgical office-based procedure to treat overactive bladder.

A small needle electrode is placed through the skin near the ankle to gently stimulate the tibial nerve. This stimulation adjusts how the brain receives sensation signals from the bladder and results in reduced urinary urgency and decreased frequency. A typical treatment takes 30 minutes in the office, and the initial treatment period involves weekly treatments for 12 weeks. Patients with beneficial effect from the initial treatment course usually then undergo maintenance treatments once monthly. Patients with pacemakers for their heart are not able to undergo PTNS.

When to ask a Urologist about Percutaneous Tibial Nerve Stimulation

You should speak with a Urologist about percutaneous tibial nerve stimulation if you have bothersome symptoms of overactive bladder not effectively treated with oral medications.

Cost

Typically covered by most insurances (although coinsurance and deductibles may apply). Some insurers require trying alternative forms of testosterone supplementation before moving on to testosterone pellets. Coverage will be verified prior to proceeding.  If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.

Effectiveness

About 60% of patients have been shown to have at least a 50% improvement in symptoms. The beneficial effect appears to dissipate around 4-6 months following the initial treatment course. Studies have shown that the same beneficial effect can last at least two years (patients were not followed beyond two years) in patients who continue with monthly maintenance treatments. Patients with significant ankle swelling may have more limited improvement due to difficulty with precise electrode placement.

Possible Side Effects

Skin irritation is possible at the electrode insertion site near the ankle. This procedure is very safe and no significant side effects have been reported.

Alternative Approaches

Other options for the management of overactive bladder include observation without treatment, lifestyle modifications, oral medications, Botox bladder injections, or placement of sacral neuromodulation device (Interstim).

What to do to Prepare for Procedure

There is no need to stop blood-thinning medications.

What to Expect after Procedure

The procedure is completed in the office and is virtually painless.