Skip to main content

Posterior Tibial Nerve Stimulation

  • Chapter
  • First Online:
Adult and Pediatric Neuromodulation

Abstract

Percutaneous Tibial Nerve Stimulation (PTNS) is a lower urinary tract neuromodulation technique involving the intermittent, weekly stimulation of the tibial nerve at the ankle. PTNS is a minimally invasive technique that requires no permanent lead or implanted stimulator. It is currently approved by the United States Food and Drug Administration (FDA) for the treatment of overactive bladder (OAB) and its associated frequency, urgency, and urgency urinary incontinence, but its uses in other clinical contexts are still under investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sanford MT, Suskind AM. Neuromodulation in neurogenic bladder. Transl Androl Urol. 2016;5(1):117–26.

    PubMed  PubMed Central  Google Scholar 

  2. Gaziev G, Topazio L, Iacovelli V, Asimakopoulos A, Di Santo A, De Nunzio C, et al. Percutaneous Tibial Nerve Stimulation (PTNS) efficacy in the treatment of lower urinary tract dysfunctions: a systematic review. BMC Urol. 2013;13:61. https://doi.org/10.1186/1471-2490-13-61.

    Article  PubMed  PubMed Central  Google Scholar 

  3. McGuire EJ, Zhang SC, Horwinski ER, Lytton B. Treatment of motor and sensory detrusor instability by electrical stimulation. J Urol. 1983;129(1):78–9.

    Article  CAS  Google Scholar 

  4. Vodusek D, Light J, Libby J. Detrusor inhibition induced by stimulation of pudendal nerve afferents. Neurourol Urodyn. 1986;5:381–9.

    Article  Google Scholar 

  5. Tai C, Shen B, Chen M, Wang J, Roppolo JR, de Groat WC. Prolonged poststimulation inhibition of bladder activity induced by tibial nerve stimulation in cats. Am J Physiol Renal Physiol. 2011;300(2):F385–92.

    Article  CAS  Google Scholar 

  6. Vandoninck V, van Balken MR, Finazzi Agro E, Petta F, Micali F, Heesakkers JP, et al. Percutaneous tibial nerve stimulation in the treatment of overactive bladder: urodynamic data. Neurourol Urodyn. 2003;22(3):227–32.

    Article  Google Scholar 

  7. Nguyen LN, Chowdhury ML, Gilleran JP. Outcomes for intermittent neuromodulation as a treatment for overactive bladder. Curr Bladder Dysfunct Rep. 2017;12(1):66–73.

    Article  Google Scholar 

  8. Finazzi Agro E, Campagna A, Sciobica F, Petta F, Germani S, Zuccala A, et al. Posterior tibial nerve stimulation: is the once-a-week protocol the best option? Minerva Urol Nefrol. 2005;57(2):119–23.

    CAS  PubMed  Google Scholar 

  9. Yoong W, Ridout AE, Damodaram M, Dadswell R. Neuromodulative treatment with percutaneous tibial nerve stimulation for intractable detrusor instability: outcomes following a shortened 6-week protocol. BJU Int. 2010;106(11):1673–6.

    Article  Google Scholar 

  10. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.

    PubMed  Google Scholar 

  11. Gormley EA, Lightner DJ, Faraday M, Vasavada SP. American Urological Association, Society of Urodynamics, Female Pelvic Medicine. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol. 2015;193(5):1572–80.

    Article  Google Scholar 

  12. Klingler HC, Pycha A, Schmidbauer J, Marberger M. Use of peripheral neuromodulation of the S3 region for treatment of detrusor overactivity: a urodynamic-based study. Urology. 2000;56(5):766–71.

    Article  CAS  Google Scholar 

  13. Peters KM, Macdiarmid SA, Wooldridge LS, Leong FC, Shobeiri SA, Rovner ES, et al. Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol. 2009;182(3):1055–61.

    Article  CAS  Google Scholar 

  14. Peters KM, Carrico DJ, Perez-Marrero RA, Khan AU, Wooldridge LS, Davis GL, et al. Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol. 2010;183(4):1438–43.

    Article  Google Scholar 

  15. van der Pal F, van Balken MR, Heesakkers JP, Debruyne FM, Bemelmans BL. Percutaneous tibial nerve stimulation in the treatment of refractory overactive bladder syndrome: is maintenance treatment necessary? BJU Int. 2006;97(3):547–50.

    Article  Google Scholar 

  16. Peters KM, Carrico DJ, Wooldridge LS, Miller CJ, MacDiarmid SA. Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study. J Urol. 2013;189(6):2194–201.

    Article  Google Scholar 

  17. MacDiarmid SA, Peters KM, Shobeiri SA, Wooldridge LS, Rovner ES, Leong FC, et al. Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol. 2010;183(1):234–40.

    Article  Google Scholar 

  18. Kessler TM, La Framboise D, Trelle S, Fowler CJ, Kiss G, Pannek J, et al. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and meta-analysis. Eur Urol. 2010;58(6):865–74.

    Article  Google Scholar 

  19. Gobbi C, Digesu GA, Khullar V, El Neil S, Caccia G, Zecca C. Percutaneous posterior tibial nerve stimulation as an effective treatment of refractory lower urinary tract symptoms in patients with multiple sclerosis: preliminary data from a multicentre, prospective, open label trial. Mult Scler. 2011;17(12):1514–9.

    Article  CAS  Google Scholar 

  20. de Seze M, Raibaut P, Gallien P, Even-Schneider A, Denys P, Bonniaud V, et al. Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Neurourol Urodyn. 2011;30(3):306–11.

    Article  Google Scholar 

  21. Ohannessian A, Kabore FA, Agostini A, Lenne Aurier K, Witjas T, Azulay JP, et al. Transcutaneous tibial nerve stimulation in the overactive bladder syndrome in patients with Parkinson’s syndromes. Prog Urol. 2013;23(11):936–9.

    Article  CAS  Google Scholar 

  22. Krivoborodov GG, Gekht AB, Korshunova ES. Tibial neuromodulation in the treatment of neurogenic detrusor hyperactivity in patients with Parkinson’s disease. Urologiia. 2006;(4):3–6.

    Google Scholar 

  23. Monteiro ES, de Carvalho LB, Fukujima MM, Lora MI, do Prado GF. Electrical stimulation of the posterior tibialis nerve improves symptoms of poststroke neurogenic overactive bladder in men: a randomized controlled trial. Urology. 2014;84(3):509–14.

    Article  Google Scholar 

  24. Chen G, Liao L, Li Y. The possible role of percutaneous tibial nerve stimulation using adhesive skin surface electrodes in patients with neurogenic detrusor overactivity secondary to spinal cord injury. Int Urol Nephrol. 2015;47(3):451–5.

    Article  Google Scholar 

  25. Paquette IM, Varma MG, Kaiser AM, Steele SR, Rafferty JF. The American Society of Colon and Rectal Surgeons’ clinical practice guideline for the treatment of fecal incontinence. Dis Colon Rectum. 2015;58(7):623–36.

    Article  Google Scholar 

  26. Horrocks EJ, Thin N, Thaha MA, Taylor SJ, Norton C, Knowles CH. Systematic review of tibial nerve stimulation to treat faecal incontinence. Br J Surg. 2014;101(5):457–68.

    Article  CAS  Google Scholar 

  27. Knowles CH, Horrocks EJ, Bremner SA, Stevens N, Norton C, O'Connell PR, et al. Percutaneous tibial nerve stimulation versus sham electrical stimulation for the treatment of faecal incontinence in adults (CONFIDeNT): a double-blind, multicentre, pragmatic, parallel-group, randomised controlled trial. Lancet. 2015;386(10004):1640–8.

    Article  Google Scholar 

  28. Rushton DN. Electrical stimulation in the treatment of pain. Disabil Rehabil. 2002;24(8):407–15.

    Article  Google Scholar 

  29. Zhao J, Nordling J. Posterior tibial nerve stimulation in patients with intractable interstitial cystitis. BJU Int. 2004;94(1):101–4.

    Article  Google Scholar 

  30. Ragab MM, Tawfik AM, Abo El-enen M, Elnady M, El-Gamal OM, El-Kordy M, et al. Evaluation of percutaneous tibial nerve stimulation for treatment of refractory painful bladder syndrome. Urology. 2015;86(4):707–11.

    Article  Google Scholar 

  31. Kabay S, Kabay SC, Yucel M, Ozden H. Efficiency of posterior tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain: a Sham-Controlled Comparative Study. Urol Int. 2009;83(1):33–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ryan M. Krlin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wolff, G.F., Krlin, R.M. (2018). Posterior Tibial Nerve Stimulation. In: Gilleran, J., Alpert, S. (eds) Adult and Pediatric Neuromodulation . Springer, Cham. https://doi.org/10.1007/978-3-319-73266-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-73266-4_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73265-7

  • Online ISBN: 978-3-319-73266-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics