Tibial Nerve Stimulation for Overactive Bladder: Does It Work?

Overactive bladder is a group of symptoms related to your bladder releasing urine at the wrong time. The most common symptom is the sudden need to urinate immediately.

Other potential symptoms of overactive bladder include:

  • leaking urine after getting the urge to urinate
  • needing to urinate eight or more times per day
  • needing to urinate at least twice at night
  • full loss of bladder control if unable to get to the bathroom

Overactive bladder is common. As many as 30 percent of men and 40 percent of women in the United States live with overactive bladder symptoms.

There are a variety of treatments available for overactive bladder, including lifestyle changes, medications that relax your bladder, and Botox injections for your bladder.

Tibial nerve stimulation, also called percutaneous tibial nerve stimulation (PTNS), is another type of treatment that can bring relief.

This article will take a closer look at tibial nerve stimulation, how it works, and any potential risks.

Tibial nerve stimulation is a form of neuromodulation. This means that nerve activity is changed through electrical impulses or medication delivered straight to the nerve or a nearby area. It can be used to treat a wide variety of conditions.

To stop overactive bladder symptoms, tibial nerve stimulation targets the lower urinary tract through the posterior tibial nerve. This is a branch of your sciatic nerve that runs from your pelvis down your leg.

During tibial nerve stimulation, an electrode will be put in your lower leg, near your ankle. This electrode will send pulses to your tibial nerve during treatment.

Tibial nerve stimulation is used for overactive bladder when other treatments, such as lifestyle changes, medication, and Botox, don’t work or you can’t tolerate the side effects.

Overactive bladder symptoms happen when the nerve signals between your brain and bladder aren’t working properly. This means that your brain and bladder don’t communicate the way they should, and your bladder can release urine at the wrong time.

Tibial nerve stimulation works by fixing this communication channel. The tibial nerve is part of the nerve bundle that controls the bladder. Stimulating this nerve helps control all the nerves that may not be working correctly, so your bladder only releases urine when it needs to.

An average course of tibial nerve stimulation for overactive bladder involves weekly treatment for about 12 weeks. This is followed by maintenance treatment that tapers off over time.

Tibial stimulation needs to be done in a doctor’s office. Although there is some research on using a non-invasive at-home device, it’s still advisable to get treated in a medical setting for safety purposes and best results.

Each tibial nerve stimulation session lasts for about 30 minutes. The electrical current for each session will be set on the highest level you can tolerate.

You might feel a pinch when the needle goes into your leg. During the session, you may feel tingling or have muscle spasms in your foot, toes, or ankle. However, the session shouldn’t be painful.

Tibial nerve stimulation is a successful treatment for many people with overactive bladder. In various studies, around 60 to 70 percent of people had an improvement in their symptoms, including 47 to 56 percent who reported going to the bathroom less often.

While a normal course of tibial nerve stimulation may be 12 weeks, prolonging and tapering the treatment increases the efficacy of treatment, with about 77 percent of people reporting improvement.

However, it’s important to note that it can take at least six treatments before you start seeing an improvement.

Combining tibial nerve stimulation with antimuscarinics — medications that relax your bladder and stop it from squeezing at the wrong time — may lead to even better results than tibial nerve stimulation alone.

Tibial nerve stimulation can also be used in children. In a 2015 study, over 66 percent of patients said that they were cured, and another 23.8 percent report significant improvement in symptoms.

There are no serious side effects associated with tibial nerve stimulation. However, during and after each session, you may experience:

  • bruising
  • pain
  • inflammation
  • minor bleeding around the needle insertion site

Tibial nerve stimulation isn’t recommended for some people. Talk with your doctor to find out whether this treatment is safe for you if you:

How long does tibial nerve stimulation take to work?

It can take up to six tibial nerve stimulation sessions to start noticing effects. The best results come after 12 weeks of consistent treatment, followed by maintenance treatment that tapers off over time.

Can a TENS unit help with overactive bladder?

There is some research being done into at-home nerve stimulators, including TENS units, but more research is needed.

Early results suggest that at-home tibial nerve stimulation is less effective than having the procedure done in a doctor’s office.

Can tibial nerve stimulation be used for children with overactive bladder?

Yes, tibial nerve stimulation can be used for children with overactive bladder. It has a good success rate in children, with about 70 percent of patients reporting significant improvement or a cure.

Can tibial nerve stimulation replace overactive bladder medications?

Overactive bladder medications will usually be tried before tibial nerve stimulation. If the medications don’t work or the side effects are severe or interfere with your daily life, your doctor may recommend tibial nerve stimulation instead.

If first-line treatments like lifestyle changes and medications don’t improve your overactive bladder symptoms, tibial nerve stimulation could be an option.

It’s a safe treatment without adverse side effects and is effective in over 60 percent of people who use this treatment.

If you have overactive bladder symptoms, talk with your doctor about whether tibial nerve stimulation might be an option for you.

https://www.healthline.com/health/overactive-bladder/tibial-nerve-stimulation-for-overactive-bladder

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