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Reviewed by: Missy Nolan

Percutaneous tibial nerve stimulation may sound intimidating, but this quick procedure helps ease the most common symptoms of an overactive bladder. Continue reading to learn more about this procedure, so you can make an informed decision about whether it's right for you. 

What Is PTNS?

Overactive bladder affects approximately 33 million people every year, making it an extremely common condition. PTNS is a nonsurgical treatment option that helps relieve common symptoms such as urinary frequency, urgency, and incontinence. PTNS works by stimulating the sacral nerve plexus — the group of nerves that regulates bladder function. In this procedure, doctors stimulate these nerves by inserting a thin needle above the ankle. It's generally painless with minimal side effects and is similar to acupuncture, making PTNS an ideal choice for those who prefer a less invasive option. 

Is PTNS Right for You?

Overactive bladder affects millions of sufferers globally, with symptoms significantly more common in women than in men. Some of the most recognizable symptoms include feeling a strong urge to urinate, urinating frequently, waking up to urinate, and experiencing leakage before reaching the restroom. Some research studies show success rates as high as 80% when it comes to symptom improvement after PTNS. If these bothersome symptoms sound familiar, PTNS might be worth considering:

Doctors may recommend PTNS for those who have tried standard treatment methods, such as lifestyle changes, avoiding bladder irritants, medications, and pelvic floor physiotherapy, and didn't find relief. If this situation sounds familiar, consider speaking with your doctor about PTNS.

PTNS Procedures 

During the PTNS procedure, you're typically seated with your foot comfortably elevated and supported. Your doctor will place a slim needle electrode, similar to an acupuncture needle, near a nerve at the ankle known as the tibial nerve. A device connected to this electrode is turned on to send gentle low-grade electric pulses up your leg to the tibial nerve, and these pulses then travel to the sacral nerve plexus that controls bladder and pelvic floor function. The procedure's electrical pulse blocks malfunctioning nerve signals that cause unwanted bladder spasms.

How Long Does PTNS Treatment Last?

Typically, patients go in for a series of about 12 weekly sessions that last around 30 minutes. These treatments don't require preparation or restriction of daily activities, so they can be easy to incorporate into your schedule. 

After 12 treatments, the doctor will assess your symptoms to determine if further treatments are necessary. If so, you'll generally require a single maintenance treatment monthly or every few months. While these maintenance treatments are required for many patients, long-term treatment frequency depends on your individual response to PTNS. Some patients simply require more treatments than others, but they may only do bimonthly maintenance treatments. Others may not require minimal maintenance treatments at all. Remember that PTNS is not surgery, so patients rarely have major discomfort or downtime.

Side Effects of PTNS Treatment for Overactive Bladder

During the procedure, you may feel gentle sensations that resemble tingling, vibrating, or pulsating. This happens around the leg, ankle or foot, but it's generally not painful, and some patients even enjoy the sensations. Another thing to note is that stimulation is only performed for 15-30 minutes at a time, so you'll get plenty of downtime to relax and rejuvenate. It generally takes around 5-7 weeks for patients to notice changes in bladder control.

After the procedure, some side effects are possible, but they're mild — if they happen at all. These include light redness, tingling, or some mild discomfort at the simulation site, but they should wear off quickly if they occur. The majority of patients experience zero post-procedure side effects. Overall, PTNS is well tolerated by most patients, who find this noninvasive procedure worthwhile for alleviating overactive bladder symptoms.

Positives Behind This Procedure:

  • 60-80% of patients improve their symptoms with PTNS and experience clinically significant improvements in urination urgency and frequency. 
  • PTNS is a low-risk procedure that's well tolerated and generally has no lingering side effects.
  • People who respond well to the first series of treatments usually only need occasional maintenance treatments post-procedure.
  • It does not involve a permanently implanted device.
  • PTNS is generally described as painless. If anything, people who have gotten this treatment describe having the sensation of tingling or pulsing in the foot or the ankle.

Why Some Shouldn’t Get PTNS

As with any procedure, not everyone qualifies for this form of treatment, which is why discussing individual details with your doctor is critical before making an informed decision. Fortunately, the list of exclusions is short and primarily due to existing medical conditions. If any of the following applies, PTNS may not be for you:

The Bottom Line

Having an overactive bladder is stressful and can make daily life difficult, but various treatment options may help alleviate discomfort. PTNS sends your nerves a wake-up signal to put your bladder to work, and as a low-risk procedure with minimal, short-term side effects, it's an effective option for many. If this procedure is of interest, reach out to your doctor to discuss your individual condition and see if PTNS may be right for you. 

If you're suffering from common overactive bladder symptoms, including a constant urge to urinate, high urinary frequency, incontinence, or nocturia, PTNS is a valuable procedure that can provide welcome relief. It takes just 12 quick sessions with little downtime and few side effects, making PTNS a wise choice for many people dealing with the stress and embarrassment of an overactive bladder. In the meantime, get Nexwear's pads and underwear delivered to your door to keep your bladder under control wherever the day takes you. 


While pursuing her nursing degree, Missy aced her medical courses and was hired as a chiropractic assistant. After her second child was born, Missy left the chiropractic office and became a full-time medical writer. Since then, she's written thousands of articles about everything from urinary incontinence to neurological conditions and digestive health. Missy also appreciates a holistic approach toward wellness and is well-versed in the benefits of combining treatments such as meditation, sound therapy, and acupuncture with traditional Western medicine.