Percutaneous Tibial Nerve Stimulation

Percutaneous Tibial Nerve Stimulation

What is Percutaneous Tibial Nerve Stimulation (PTNS)?

Percutaneous Tibial Nerve Stimulation is a treatment for an overactive bladder and symptoms associated with urinary urgency, urinary frequency, and urge incontinence. Other treatment options include behavior medication, pelvic muscle strengthening, drug therapy, and surgery.


For this treatment, a small slim needle electrode will be temporarily inserted near your ankle and connected to a battery-powered simulator. The stimulator’s impulses will travel through the tibial nerve to the sacral nerve plexus, the nerves controlling bladder function.

During treatment, you will sit in a chair with your leg elevated. A clinician will clean your ankle and find the right place to insert the needle electrode (you may feel a slight tap as the needle pierces the skin), attach a grounding pad to the arch of your foot, and connect components. The clinician will turn on the stimulator and adjust the settings. You will feel a sensation in your ankle or foot. Your toes may flex or fan. Let your clinician know if the sensation is too intense or if you are uncomfortable. You will remain comfortably seated during the 30-minute treatment. The clinician will adjust settings during treatment if needed. In the end, your clinician will disconnect you, and you will resume normal activities. You will continue treatment for 12 weekly, 30 minute sessions. If you respond, additional treatments will be needed to sustain results.


Potential side effects include discomfort and pain near the stimulation site, redness/inflammation at or near the stimulation site, local bleeding, toe numbness, or stomach ache.

Individuals with pacemakers, implantable defibrillators, prone to excessive bleeding, and nerve damage that could impact either percutaneous tibial nerve or pelvic floor function, women who are pregnant or planning to become pregnant should refrain from having this treatment.