Overactive bladder (OAB) affects millions of adults, with profound personal and economic costs. Although drug treatment (antimuscarinic drugs) can reduce voiding symptoms, the effect is modest, and many patients are intolerant of the side effects, or do not experience sufficient relief. For these patients, PTNS – percutaneous tibial nerve stimulation -– is proposed as a next step in overactive bladder care.
Urgency incontinence or OAB is caused by overactive detrusor muscle activity during bladder filling. The initial treatment option for OAB is behavioral therapy aimed at altering the patient’s habits and response to the subjective sense of urgency. Despite the fact that this therapy is often effective, many patients, called non-responders, do not improve enough to meet their expectations. In these non-responders, drug treatment is the future step. These drugs suppress bladder symptoms by lowering the sensitivity of the detrusor muscle receptors, so there is not so much urge. When behavioral therapy or drug treatment strategies is not effective, PTNS is suggested as the next therapeutic intervention.
A number of clinical studies have found that PTNS for OAB demonstrates effectiveness without major safety concerns. The United States Food and Drug Administration (FDA) has cleared PTNS for treatment of overactive bladder and the associated symptoms of urinary frequency, urinary urgency and urinary urge incontinence. This treatment is approved by Medicare.
PTNS uses intermittent (weekly) stimulation of the tibial nerve at the ankle with no permanent lead or stimulator implanted. PTNS is provided in the outpatient clinic setting. A small, 34-gauge needle electrode is inserted into the arch of the foot and very low electrical stimulation is performed for 30 minutes weekly for 12 weeks.
Research studies have demonstrated that as many as 80% of the patients in a study were cured or their symptoms greatly relieved, as compared to 60% of the patients who were on drug treatment.
PTNS Treatment is provided by Urology Group of New Mexico, Talk to Dr. Snoy or one of the medical staff about this treatment option.
For more information visit US National Library of Medicine, National Institutes of Health