Electrical stimulation of the nerves that control the bladder can improve symptoms of urgency, frequency and urge incontinence, as well as bladder emptying problems, in some people. This treatment is usually offered to patients who cannot tolerate or do not benefit from medications. There are two different ways that this electrical stimulation can be delivered.

PTNS (percutaneous tibial nerve stimulation) is a non-surgical way in which electrical stimulation is delivered through a series of office treatments. A thin needle is temporarily placed near your ankle. The needle is then connected to a battery powered stimulator. After turning on the stimulator, mild electrical impulses travel up the nerves in the leg to the nerves that control your bladder function. Your physician will observe your body’s response to determine the ideal level for nerve stimulation. You will receive 12 weekly, 30 minute treatments to start. Occasional treatments, usually about once a month, may be needed to sustain your improvements.

SNS (sacral nerve stimulation) delivers electrical stimulation through a device surgically implanted in your buttocks. The first step is a test stimulation during which your doctor will place a device outside your body (lower back, near your tailbone) to deliver stimulation through a wire implanted under your skin to see if the treatment relieves your symptoms. This stimulator provides low-voltage stimulation to the sacral nerves; in many cases, this stimulation can improve the function of the bladder. You will go about your daily life for several days, keeping track of how your bladder is functioning. If significant improvement is seen, you may be able to have a permanent device (similar to a pacemaker) implanted that delivers stimulation to the nerves in your back. The electrodes in the permanent device are placed in your lower back through a minor surgical procedure. The device can provide benefit for several years before the battery needs to be replaced. You may need to return to your doctor for adjustments to find the right setting that controls your bladder symptoms. This can be done at home or in the doctor’s office with a device similar to a TV remote control.

Sources
American Urogynecologic Society
Original publication date: May, 2008