New Treatments for Overactive Bladder (PTNS)
New Treatments for Overactive Bladder
Millions of women worldwide suffer from overactive bladder (OAB). Symptoms of OAB include a sudden and intense urge to urinate, urine leakage when the urge is felt, frequent urination during the day, and waking up many times during the night to urinate. OAB symptoms can be treated with bladder retraining or medication. Unfortunately, some women either do not experience improvement in their symptoms with medication or experience unwanted side effects from the medications. For these women, there are additional treatment options that may help control OAB symptoms. One of these treatment options is Percutaneous Tibial Nerve Stimulation (PTNS).
What Is PTNS (Percutaneous Tibial Nerve Stimulation)?
PTNS (Percutaneous Tibial Nerve Stimulation – Neuromodulation) is a new treatment method that supports the proper functioning of the anal muscles by stimulating the nervous system. The PTNS method is easily applied in the treatment of conditions such as an overactive bladder, urinary incontinence, inability to control gas or stool, difficulty defecating, and chronic constipation, and is non-invasive for the patient.
For Which Diseases Is the PTNS Method Used?
- In overactive bladder syndrome
- Inability to control gas and stool
- Urinary incontinence
- Chronic Constipation Disorders
- In some cases of difficulty with defecation
When the urge to urinate or defecate arises, the nervous system sends signals to the brain, and in response to these signals, the brain sends commands to the muscles to contract and relax. As a result of certain diseases, this system—which enables urination or defecation—becomes impaired. Due to this impairment, the muscles can no longer contract and relax as needed. This condition causes individuals to involuntarily urinate or defecate.
The PTNS system aims to restore the functional connection between the brain and the muscles to provide control over urination and bowel movements. In this way, it regulates the contraction and relaxation commands between the brain and the nervous system, similar to the process of toilet training learned in infancy.
What Are the Results Obtained Using the PTNS Method?
The findings from studies conducted on the recently implemented PTNS are as follows:
– Success rates of 60–80 percent are achieved in the treatment of overactive bladder, also known as urinary incontinence,
– Significant reductions in the number of urinary leaks during the day and night are achieved,
– Long-term improvement is observed in 78 percent of patients treated for anal incontinence, also known as fecal and gas incontinence.
How Is the PTNS Method Applied?
The PTNS device resembles a television remote control in appearance. The intensity and frequency of the electrical stimulation can be adjusted using the various buttons on the device. The device is attached to the ankles. This is because the nerves that transmit signals to the anal sphincter muscles can be stimulated through the ankles.
The PTNS device uses two electrodes. One electrode is attached to the sole of the foot, while the other is connected to a thin acupuncture needle placed on the inner side of the ankle. After selecting the appropriate setting on the remote control, the patient can spend the 30-minute session reading a book or simply resting. The device automatically cycles on and off at regular intervals throughout the 30-minute session. Depending on the severity of the condition, the intensity of the electrical stimulation can be increased. Even when used at the highest intensity levels, the PTNS device does not cause pain or discomfort to the patient.
How Often Is the PTNS Device Used?
Each PTNS session lasts 30 minutes. The program is typically administered in a hospital setting under the supervision of a doctor or nurse for 8 to 12 weeks. The initial treatment duration (number of sessions and number of weeks) and follow-up for these programs may vary depending on the type of condition.