Percutaneous Tibial Nerve Stimulation

Percutaneous tibial nerve stimulation (PTNS) is a minimally invasive neuromodulation treatment for use in overactive bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence when more conservative measures have failed. (1) In an outpatient setting, with the patient in a sitting position, a very small needle is inserted beneath the skin just above the ankle (a bit like  acupuncture), and attached to a handheld pulse generator unit that electrically stimulates the posterior tibial nerve. This stimulation sends signals back to nerves controlling the bladder and pelvic floor muscles. Treatment lasts 30 minutes per week for 12 weeks. If  and when symptoms recur, patients may return occasionally for maintenance treatment. (2)

PTNS is also being explored as a potential alternative to sacral nerve stimulation in cases of fecal incontinence. (3)


  1. Uroplasty, Inc, Minnetonka, MN USA Accessed Jan. 28, 2013.

  2. Peters, K. M., Carrico, D. J., MacDiarmid, S. A.,  Wooldridge, L. S., Khan, A. U., McCoy, C. E., Franco, N. and  Bennett, J. B. (2013), Sustained therapeutic effects of percutaneous  tibial nerve stimulation: 24-month results of the STEP study. Neurourol. Urodyn., 32: 24–29.

  3. Health Technology Assessment Programme. CONtrol of Faecal  Incontinence using Distal NeuromodulaTion (CONFIDeNT). Accessed May 31, 2012.

Reviewed Feb. 2, 2013
Prof. C.H Knowles, BChir, PhD, FRCS (Gen Surg)
Member, International Neuromodulation Society
Clinical Professor of Surgical Research and Hon Consultant Colorectal Surgeon, Centre for Digestive Diseases, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London

Last Updated on Sunday, November 21, 2021 08:16 PM