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Home Offer Treatments Percutaneous tibial nerve stimulation (PTNS)

An effective neuromodulation treatment for incontinence and chronic pain

What is percutaneous tibial nerve stimulation (PTNS)?

Percutaneous tibial nerve stimulation (PTNS) is an innovative neuromodulation treatment in which the tibial nerve, an important nerve on the shin, is stimulated in a targeted manner. Neuromodulation refers to the targeted influencing of nerve functions in order to positively change the function of organs or bodily processes. In the case of PTNS, this method can effectively improve the functioning of the bladder and urinary and fecal sphincter, making it a valuable option in the treatment of incontinence and other urological conditions.

Areas of application for PTNS

PTNS is primarily used in the following areas:

  • overactive bladder (urge incontinence): The most common use of PTNS is to treat an overactive bladder that leads to involuntary leakage of urine. Studies show that up to 60% of patients experience a significant calming of the bladder with PTNS. This treatment option is particularly suitable for patients who cannot tolerate medication for urge incontinence (such as anticholinergics) or for whom this medication is not effective. It is also a sensible alternative if Botox therapy is not possible or not desired.
  • Fecal incontinence: Neuromodulation of the tibial nerve can also be effective for urge incontinence, i.e. involuntary loss of stool. This application is particularly relevant for patients suffering from both forms of incontinence.
  • Chronic pelvic pain syndrome (PPS): Another area of application for PTNS is the treatment of chronic pelvic pain syndrome, also known as chronic prostatitis. By stimulating the tibial nerve, the pelvic floor can be calmed, which leads to relief from the cramp-like pain.

How PTNS works

PTNS is performed by targeted stimulation of the tibial nerve using a very fine acupuncture needle. This needle transmits weak electrical impulses to the tibial nerve, which triggers an increased nerve stimulus. This stimulus is processed in the spinal cord in the so-called sacral micturition center, which also controls the nerves responsible for controlling the bladder and sphincter.

The PTNS therapy procedure

PTNS is a minimally invasive procedure that is performed on an outpatient basis. A full course of therapy usually consists of 12 sessions spread over 12 weeks, with one session per week lasting around 30 minutes. Many patients notice an improvement in their symptoms after the fourth to sixth session. If the therapy is successful, maintenance therapy is recommended every 3 weeks.

Side effects and risks of PTNS

PTNS is a very safe and well-tolerated treatment method with minimal side effects. The most common side effects include slight redness and short-term pain at the point where the acupuncture needle is inserted. In rare cases, inflammation may occur at the puncture site. Some patients report a feeling of pressure in the stomach area during the treatment, but this disappears immediately after the end of the session. PTNS is also not associated with long-term risks such as stomach ulcers.

Scientific acceptance

Although PTNS is not yet widely used in Switzerland, it has passed internationally recognized scientific tests and is anchored in several urological guidelines, among others. These include the guidelines of the European Association of Urology (EAU) and the recommendations of the British NICE guidelines.

Conclusion

Percutaneous tibial nerve stimulation (PTNS) offers an effective, minimally invasive treatment option for patients with involuntary loss of urine and stool and chronic pelvic floor pain. Thanks to its good tolerability and proven efficacy, PTNS is a valuable alternative to drug or surgical treatments, especially for patients who do not respond to other therapies.