Percutaneous Tibial Nerve Stimulation (PTNS)
WHAT IS PTNS?
Percutaneous Tibial Nerve Stimulation (PTNS) is a treatment for some types of urinary and faecal incontinence.
It is a type of treatment known as ‘neurostimulation’, where a fine needle placed into your ankle transmits small electrical impulses through a nerve in your leg (the tibial nerve) to the sacral nerve plexus in your lower spine area. The sacral nerves control the bowel and bladder.
The exact mechanism by which this works is not fully understood, but stimulating these nerves can improve bladder and bowel function in many people.
HOW EFFECTIVE IS PTNS?
PTNS is not a cure for incontinence, but it can help to control symptoms.
60-80% of patients with faecal incontinence will see an improvement in symptoms.
WHAT WILL HAPPEN AT MY appointment?
The nurse will explain the procedure to you and ask you some questions about your health to check that the treatment is suitable and safe for you. You will be asked to sign a consent form.
You will then be asked to sit on a chair or lie on a couch in a private room. A small, very slim needle (which looks similar to those used in acupuncture) will be inserted into your ankle. This will be connected to a battery-powered stimulator. A sticky electrode will be placed on the sole of your foot, and the level of stimulation will be gradually increased until you feel a tingling or prickly sensation in your foot. Most people do not find this uncomfortable or painful.
You will then sit for 30 minutes, during which you may relax and read if you wish. The machine will switch itself off and the nurse will remove the needle.
HOW MANY TREATMENTS WILL I NEED?
To start with you will normally need:
- A course of 12 treatments. It is important that these are at weekly intervals, so make sure that when you start your treatment you are able to book a run of twelve weeks without a break.
- 2 further treatments at two week intervals
- One more treatment after one month
You will be asked to fill in a weekly bowel diary to monitor your symptoms. You should start to see an improvement after six sessions.
The initial course of treatment is effective for up to six months. After this time you will need 1-3 ‘top-up’ sessions every six months or so to stop the symptoms coming back.
Each treatment lasts approximately 30 minutes, though you should allow an hour for your first appointment.
ARE THERE ANY RISKS?
This treatment is very safe. The level of stimulation is very low and it does not damage the nerves. You may experience some temporary tingling, discomfort or occasionally some throbbing pain near the stimulation site.
Occasionally redness/inflammation can occur at the needle site, and slight bleeding or a little bruising may be seen when the needle is taken out. Toe numbness, or stomach or back ache, are occasionally reported.
IS PTNS SUITABLE FOR ME?
PTNS treatment is safe and effective for most people.
It is not suitable for people with certain conditions, or where neurostimulation has been tried before and failed. These include patients who have a pacemaker or implantable defibrillators, are prone to excessive bleeding, have certain types of nerve damage and are pregnant or planning to become pregnant during the duration of the treatment. Your doctor and nurse will carry out a thorough assessment of your medical history to make sure that PTNS is safe and likely to work for you.
WHAT HAPPENS THEN?
You may find this manufacturer’s pdf leaflet helpful as it provides further information and links to reference material.
The following link will take you to the manufacturer’s website: www.PTNS.org