Understanding Electroacupuncture for Overactive Bladder: A Patient's Guide to PTNS Treatment

What is Overactive Bladder and How Does it Affect You?

Do you frequently rush to the bathroom? Wake up multiple times at night to urinate? Feel sudden, strong urges to urinate that are difficult to control? These symptoms could indicate overactive bladder syndrome (OAB), a common condition affecting millions of people worldwide.

Overactive bladder isn't just a physical issue—it can significantly impact your quality of life. Many patients report feeling embarrassed, avoiding social activities, planning trips around bathroom locations, and experiencing disrupted sleep. If you're dealing with these challenges, you're not alone, and there are effective treatments available.

When medications and behavioral therapies haven't provided sufficient relief, a treatment called electroacupuncture—specifically a technique known as Percutaneous Tibial Nerve Stimulation (PTNS)—might be worth considering. This guide explains this treatment in simple terms to help you understand how it works and whether it might be right for you.

From Ancient Wisdom to Modern Treatment: How PTNS Evolved

You might be surprised to learn that this modern treatment has roots in ancient healing practices. PTNS developed from traditional Chinese acupuncture techniques that have been used for thousands of years.

In traditional acupuncture, practitioners work with specific points on the body that are believed to influence certain organs and systems. One important point on the inside of the lower leg, is exactly where modern PTNS treatment targets the tibial nerve!

When traditional acupuncture incorporates electrical stimulation, it's called electroacupuncture. PTNS works in a similar way but focuses specifically on stimulating the tibial nerve with precise electrical pulses rather than working with the traditional concept of energy pathways.

The modern version of this treatment was first described by medical researchers in the early 1980s, creating a bridge between ancient healing arts and contemporary medical science.

How Does PTNS Work? Understanding the Basics

You might be wondering how stimulating a nerve in your ankle could possibly help your bladder. It's a great question! While medical researchers are still studying all the details, here's what we know in simple terms:

Think of your body's nervous system like a complex telephone network. The tibial nerve in your ankle connects to the same area in your spine that controls your bladder. When we stimulate the tibial nerve with gentle electrical pulses, it sends signals that help "reset" the abnormal bladder activity patterns.

Your body has natural ways to control when your bladder contracts, but with overactive bladder, these control mechanisms aren't working properly. PTNS helps strengthen these natural control systems by:

1. Calming the overactive bladder muscle (called the detrusor)

2. Improving communication between your nervous system and bladder

3. Activating your body's natural pain-control chemicals

This isn't like taking medication that works temporarily—PTNS helps retrain your body's own systems gradually over several treatment sessions.

What to Expect During PTNS Treatment: A Patient's Experience

If you're considering PTNS treatment, it helps to know what the procedure involves. Here's what you can expect:

Before Your First Appointment

- Your healthcare provider will review your medical history and confirm you're a good candidate for the treatment

- You don't need to do any special preparation before appointments

- You can eat and drink normally before treatment

During the Treatment Session

1. Getting Comfortable: You'll be seated comfortably in a chair with your treatment leg elevated

2. Simple Procedure: Your provider will clean the area around your ankle and insert a very thin needle near your ankle bone and lower leg.

3. Gentle Stimulation: A small Electro Acupuncture lead will be placed at the needles will be connected to a device that delivers mild electrical pulses

4. Relaxation Time: Each treatment lasts about 30 minutes, during which many patients read, rest, or use their phones

5. Sensations: Most patients feel a tingling, pulsing, or mild vibrating sensation in their foot or toes—this is normal and means the treatment is working correctly

What It Feels Like

"Many patients describe the sensation as pulsating or tingling in the ankle and foot. The sensations are never painful, and some even find it relaxing!" Most patients report the needle insertion feels similar to receiving acupuncture.

Treatment Schedule

- Standard treatment involves 12 weekly sessions of 30 minutes each

- Most patients begin to notice improvements after 5-7 weeks

- After completing the initial 12 sessions, maintenance treatments (usually monthly) help preserve the benefits

- It's important to complete all 12 initial treatments to properly evaluate effectiveness

Does PTNS Really Work? What Research Tells Us

You may be wondering whether PTNS is actually effective or just another treatment that makes big promises but delivers small results. Let's look at what scientific studies have found:

Success Rates

Multiple studies have shown that PTNS helps a significant number of patients with overactive bladder:

- In a comprehensive review of research, between 37% and 100% of patients experienced improvement with PTNS treatment

- One study found that 71% of patients receiving actual PTNS treatment improved, while none of the patients receiving a "pretend" treatment showed improvement

- Most patients notice improvements in:

- How often they need to urinate during the day and night

- How urgently they feel the need to use the bathroom

- How many episodes of leakage they experience

Comparing PTNS to Other Treatments

A study with 105 participants compared three approaches:

1. PTNS treatment alone

2. Medication alone (solifenacin, a common OAB medication)

3. Both treatments combined

The results? PTNS alone worked better than medication alone. Not surprisingly, the combination of both treatments provided the greatest improvement and lasted longest.

Long-Term Benefits

Research shows that the benefits of PTNS typically last for one to three months after completing the initial treatment series. This is why maintenance treatments are usually recommended to keep symptoms under control.

Why Consider PTNS? Advantages Over Other Treatments

If you've tried medications or behavioral techniques for your overactive bladder with limited success, PTNS might offer several advantages:

Compared to Medications

- Fewer Side Effects: Many OAB medications can cause bothersome side effects like dry mouth, constipation, blurry vision, and drowsiness. Some research even suggests certain OAB medications may be associated with an increased risk of dementia with long-term use.

- Comparable Effectiveness: Studies show PTNS works as well as or better than many OAB medications. One research study found PTNS was more effective than a common medication called solifenacin.

- No Drug Interactions: Since PTNS isn't a medication, it doesn't interact with other drugs you might be taking.

Compared to Surgery

- No Anesthesia Needed: PTNS doesn't require general anesthesia or hospitalization

- Non-Surgical: There's no cutting or permanent implantation of devices

- Reversible: If you decide to stop treatment, there are no lasting effects to worry about

- Lower Risk: The procedure has minimal risks compared to surgical interventions

Compared to Behavioral Techniques Alone

Research shows that when PTNS is added to bladder training exercises, patients experience better results than with bladder training alone.

Safety Profile

PTNS is generally very well-tolerated with minimal side effects. The most common issues reported are:

- Mild temporary discomfort during the needle insertion

- Minor skin irritation at the needle site

- Occasional mild muscle twitching during treatment

These effects are typically very minor and go away quickly after the treatment session ends.

Is PTNS Right for Me? Important Considerations

While PTNS offers many benefits, it's important to understand its limitations and whether it's appropriate for your situation:

When PTNS Is Typically Recommended

Most healthcare providers consider PTNS a "third-line" treatment. This means they usually recommend trying these approaches first:

1. First-line: Behavioral techniques (bladder training, scheduled toileting, fluid management)

2. Second-line: Medications (anticholinergics, beta-3 agonists)

3. Third-line: PTNS and other similar treatments

If you haven't seen sufficient improvement with the first two approaches, PTNS might be your next step.

Time Commitment

PTNS requires a significant time commitment:

- Weekly office visits for 12 weeks (30 minutes each)

- Monthly maintenance treatments afterward

Who Should Not Have PTNS

PTNS is not recommended for everyone. You should not have this treatment if you:

- Have an implantable defibrillator

- Have nerve damage of the tibial nerve

- Have a tendency to bleed excessively

- Are pregnant or planning to become pregnant during treatment

Maintaining Results

It's important to know that the benefits of PTNS typically don't last permanently without maintenance treatments. In one small study, 7 out of 11 patients reported their symptoms returned after taking a 6-week break from treatment. So a Maintenance plan will be discussed with your provider.

What's on the Horizon? Future of PTNS Treatment

The field of PTNS is advancing rapidly, with exciting developments that could make treatment more convenient and effective:

Home-Based Treatment Options

Researchers are developing versions of tibial nerve stimulation that might not require regular office visits:

- Transcutaneous tibial nerve stimulation (TTNS) uses electrode pads on the skin instead of needles

- Some early studies show TTNS might provide similar benefits to traditional PTNS but with less discomfort

- This approach could potentially be used at home after initial training

Implantable Devices

New implantable devices are being developed and tested:

- These small devices would be implanted above the ankle near the tibial nerve

- Once implanted, you could activate and adjust the stimulation yourself

- This would eliminate the need for repeated office visits and needle insertions

- Some of these devices are currently in clinical trials with the FDA

Ongoing Research

Scientists are continuing to study PTNS to answer important questions like:

- What's the ideal schedule for maintenance treatments?

- Are there ways to predict which patients will respond best?

- How exactly does PTNS work on the brain and nervous system?

- Could combining PTNS with other treatments provide even better results?

As this research progresses, we can expect PTNS treatments to become more convenient, personalized, and effective in the coming years.

Taking the Next Step: Finding Expert PTNS Care

Living with overactive bladder can be challenging, affecting everything from your sleep to your social life. If you've tried lifestyle changes and medications without getting the relief you need, electroacupuncture through PTNS might be worth considering.

PTNS offers a unique approach that bridges ancient healing wisdom with modern medical technology. The treatment is minimally invasive, has few side effects, and has helped many patients regain control of their bladder function and improve their quality of life.

Expert Care at South Slope Acupuncture & Wellness

For those seeking expert PTNS treatment, South Slope Acupuncture & Wellness offers specialized care in electroacupuncture and PTNS therapy. Their practitioners combine traditional Chinese medicine knowledge with modern electroacupuncture techniques to deliver personalized and effective treatment.

At South Slope Acupuncture & Wellness, you'll receive:

- Comprehensive evaluation of your OAB symptoms and medical history

- Personalized treatment plans combining PTNS with complementary approaches

- Treatment from practitioners with extensive training in both traditional acupuncture and modern electroacupuncture techniques

- Comfortable treatment environment and flexible scheduling options

- Ongoing support throughout your PTNS treatment journey

The combination of traditional acupuncture expertise and modern PTNS protocols makes South Slope Acupuncture & Wellness an excellent choice for patients seeking this innovative treatment approach.

Is PTNS Right for You?

Research consistently shows that PTNS can be effective even when other treatments have failed. For many patients, this treatment has meant fewer bathroom trips, better sleep, less anxiety about finding bathrooms, and greater confidence in social situations.

If you're interested in exploring whether PTNS might be right for you:

- Schedule a consultation at South Slope Acupuncture & Wellness to discuss your current OAB symptoms

- Ask specifically about their approach to PTNS and their success rates

- Consider the time commitment required and whether it fits your lifestyle

Remember that while PTNS isn't a cure for overactive bladder, it offers another valuable tool that might help you manage your symptoms more effectively and reclaim aspects of your life that OAB has disrupted.

Every person's journey with overactive bladder is unique. The right treatment approach for you depends on many factors, including your specific symptoms, medical history, and personal preferences. By working with the experienced practitioners at South Slope Acupuncture & Wellness, you can develop a treatment plan that best meets your individual needs.

If you’re ready to explore how Acupuncture can benefit you in optimizing your bladder health and goals, contact us at South Slope Acupuncture & Wellness to schedule a session!

For more information or to schedule a consultation, contact us at South Slope Acupuncture and Wellness!

Remember, you do not need to wait to begin your journey to better health. Book a free 15-minute meet and greet to get started.

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 Disclaimer:

This blog post is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding overactive bladder or any other medical condition.*

References and Further Reading

1. Gaziev G, Topazio L, Iacovelli V, et al. Percutaneous tibial nerve stimulation (PTNS) efficacy in the treatment of lower urinary tract dysfunctions: a systematic review. BMC Urol. 2013;13:61.

2. MacDiarmid SA, Peters KM, Shobeiri SA, et al. Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol. 2010;183(1):234-240.

3. Nguyen LN, Chowdhury SR, Lim L, et al. The Investigation of Percutaneous Tibial Nerve Stimulation (PTNS) as a Minimally Invasive, Non-Surgical, Non-Hormonal Treatment for Overactive Bladder Symptoms. Healthcare (Basel). 2023;11(10):1426.

4. Periyasamy R, Monga A, Wong V. Posterior tibial nerve stimulation for overactive bladder—techniques and efficacy. Int Urogynecol J. 2020;31(9):1775-1782.

5. University of Colorado Urogynecology. Percutaneous Tibial Nerve Stimulation (PTNS). 2020.

6. Lim G, Mou T. Tibial nerve stimulation for overactive bladder treatment. Medical News Today. 2022.

7. Moossdorff-Steinhauser HF, Berghmans B. Effects of percutaneous tibial nerve stimulation on adult patients with overactive bladder syndrome: a systematic review. Neurourol Urodyn. 2013;32(3):206-214.

8. de Wall LL, Heesakkers JP. Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome. Res Rep Urol. 2017;9:145-157.

9. The Woman's Center. Percutaneous Tibial Nerve Stimulation (PTNS): What You Need To Know.

10. Eryılmaz R, Kaya S, Çelik S, et al. Efficacy of percutaneous and transcutaneous tibial nerve stimulation in women with idiopathic overactive bladder: A prospective randomised controlled trial. J Obstet Gynaecol. 2021;41(7):1148-1156.

11. Kim J, Lin Y, Kim Y, et al. Electroacupuncture to treat with Overactive Bladder in Postmenopausal Women: study protocol for a multicenter, randomized, controlled, parallel clinical trial. Trials. 2018;19(1):494.

Additional Resources for Patients

* Urology Care Foundation: www.urologyhealth.org

* National Association for Continence: www.nafc.org

* American Urological Association: www.auanet.org/patient-information