The Posterior Tibial Nerve Stimulation (PTNS) procedure is a minimally invasive treatment primarily used to manage overactive bladder (OAB) and associated symptoms such as urinary urgency, frequency, and incontinence. Here are the key details:
What is PTNS?
PTNS involves electrical stimulation of the posterior tibial nerve, which is located near the ankle. The posterior tibial nerve is connected to the sacral nerve plexus, which influences bladder and pelvic floor function.
How is the Procedure Performed?
- The patient sits comfortably, and the treatment area (just above the ankle) is cleaned.
- A thin needle electrode is inserted near the tibial nerve.
- A surface electrode is placed on the same leg.
- The needle electrode delivers mild electrical impulses to the tibial nerve through a handheld stimulator device.
- Each session lasts about 30 minutes.
- Typically, an initial course involves 12 weekly sessions. Maintenance sessions may be needed periodically.
Mechanism of Action
The electrical impulses delivered during PTNS therapy stimulate the tibial nerve, which in turn modulates the neural pathways that control bladder function. This neuromodulation helps to restore normal bladder activity and reduce symptoms of OAB.
Efficacy and Benefits
- Many patients experience significant improvements in urinary urgency, frequency, and incontinence.
- The procedure is non-surgical and does not require anesthesia.
- Performed in a clinic setting with no downtime.
- Suitable for patients who cannot tolerate or do not respond well to medications.
Risks and Side Effects
- Some patients may experience slight discomfort or pain at the needle insertion site.
- Bruising, bleeding, or skin irritation may occur but are usually transient.
- Infection or nerve damage is rare.
Candidates for PTNS
- Patients with OAB who have not responded to conservative treatments like lifestyle modifications and medications.
- Individuals looking for non-surgical options to manage bladder symptoms.
- Patients without contraindications such as pacemakers or certain neurological conditions.
Follow-Up and Maintenance
- After the initial 12-week course, patients may need maintenance sessions every 4-6 weeks to sustain symptom relief.
- Regular follow-up with the healthcare provider is essential to monitor progress and adjust treatment as needed.
PTNS is a well-tolerated and effective option for many patients with overactive bladder, providing significant symptom relief with a low risk of complications.