PTNS (Percutaneous Tibial Nerve Stimulation) – Over Active Bladder (OAB) at North Downs Hospital in Caterham

PTNS is a simple and safe way to improve your bladder control for an over active bladder without major side effects or invasive interventions.

What causes an over active bladder? 

Bladder function is a complex interaction between bladder, brain, spinal cord and peripheral nerves. With an OAB, this coordination does not work as it should. Instead, bladder nerves continually send signals to your brain that your bladder should be emptied even when it is not full.

How does PTNS therapy work?

PTNS therapy offers a gentle and gradual approach to modifying overactive bladder (OAB) signals. During treatment, mild electrical impulses are delivered through an acupuncture-like needle placed near your ankle. These impulses travel along the tibial nerve in your leg, ultimately reaching the nerves responsible for controlling bladder function.

What should I expect whilst having the treatment?

Patients have described various sensations during PTNS treatment. Some experience a numbing or tingling feeling, while others notice a pulsating or vibrating sensation as the therapy is administered. 

How often will I have the treatment?

Each session lasts for around 30 minutes, giving you time to relax, read, play games, or catch up on emails. 

Initially, you'll attend 12 weekly sessions to assess your response to the therapy. Many patients begin noticing improvements after about six treatments, though it may take up to 12 weeks to experience significant results. 

After this, periodic maintenance sessions are recommended to ensure long-term relief.  

How much does PTNS treatment cost?

The cost of the treatment will be explained to you before you start your 12-week course. The charges for each visit will be invoiced to you following each treatment.

What to expect during and after PTNS treatment

During treatment

• Sensations - patients typically experience mild tingling, vibrating, or pulsating sensations near the ankle or foot during the procedure. Some may feel a numbed or throbbing sensation, which is generally well-tolerated.  

• Comfort - the treatment is conducted while you are seated comfortably, with your leg elevated. You can read, play games, or relax during the 30-minute session.  

• Adjustments - your healthcare provider will adjust the electrical impulses to ensure the treatment is effective yet comfortable.  

After treatment

• Immediate recovery - PTNS is non-invasive, so patients can resume normal activities immediately after each session.  

• Symptom relief - improvements in symptoms, such as reduced urinary urgency and frequency, are often noticeable after 6 sessions, with optimal results typically achieved after 12 weeks.

• Maintenance - periodic maintenance sessions may be required to sustain long-term relief. 

Other treatments for OAB  

• Medications - while anticholinergic drugs and beta-3 agonists are effective for many, they can cause side effects like dry mouth, constipation, or dizziness. PTNS offers a drug-free alternative with fewer systemic side effects.  

• Botulinum toxin injections - into the bladder are another option for OAB, but they involve more invasive procedures and carry risks like urinary retention. PTNS is minimally invasive and avoids these complications.  

• Surgical options - procedures like sacral nerve stimulation or bladder reconstruction may be recommended for severe cases.  

How does PTNS improve your quality of life? 

Patients who complete PTNS therapy often report:  

• Enhanced bladder control - reduced urgency, frequency, and incontinence, leading to fewer interruptions in daily life.  

• Better sleep – not needing to go for a pee as much in the night allows for more restful nights.  

• Increased confidence - relief from OAB symptoms helps patients regain confidence in social and professional settings.  

• Overall wellbeing - the non-invasive nature of PTNS contributes to a positive treatment experience with minimal stress or discomfort.  

FAQs