Name of the Procedure:

Posterior Tibial Neurostimulation (PTNS), Percutaneous Needle Electrode, Single Treatment, Includes Programming

Summary

Posterior Tibial Neurostimulation (PTNS) is a minimally invasive treatment involving the insertion of a small needle electrode near the ankle to stimulate the posterior tibial nerve. This procedure aims to improve bladder function by modulating nerve activity.

Purpose

PTNS addresses overactive bladder symptoms, including frequent urination, urgency, and urge incontinence. It aims to normalize bladder activity and improve the quality of life for individuals with urinary control issues.

Indications

• Overactive bladder (OAB)
• Urge urinary incontinence
• Urinary frequency
• Urinary urgency
• Patients who have not responded to or cannot tolerate medication

Preparation

• No specific fasting or special preparations are typically needed.
• Patients may be advised to empty their bladder before the procedure.
• A brief medical history and physical examination are performed to ensure suitability.

Procedure Description

1. The patient is seated comfortably with their foot elevated.
2. A fine needle electrode is inserted near the ankle where the posterior tibial nerve is located.
3. An adhesive ground electrode is placed on the same leg.
4. Electrical impulses are delivered through the needle electrode, stimulating the nerve.
5. The stimulation parameters are programmed and adjusted for optimal response.
6. The procedure is typically pain-free, though some patients might feel a mild tingling sensation.

Duration

The procedure typically takes about 30 minutes.

Setting

PTNS is usually performed in an outpatient clinic or an office setting.

Personnel

• Trained healthcare providers, such as a physician, nurse practitioner, or a specialized technician.

Risks and Complications

• Mild discomfort or tingling at the needle insertion site
• Minor bruising or bleeding
• Rare risk of infection
• Temporary minor irritation where the electrodes are placed

Benefits

• Improved bladder control
• Decrease in symptoms of overactive bladder
• Enhanced quality of life
• Benefits may be realized within a few weeks of regular treatments

Recovery

• Patients can resume normal activities immediately after the procedure.
• No downtime is typically required.
• Follow-up treatments are usually scheduled weekly for 12 weeks.

Alternatives

• Medications (anticholinergics, beta-3 agonists)
• Behavioral therapies (bladder training, pelvic floor exercises)
• Other neuromodulation therapies (e.g., sacral nerve stimulation)
• Bladder Botox injections

Patient Experience

• Patients generally report minimal discomfort.
• Some may experience a mild tingling sensation during the electrical stimulation.
• Pain is usually managed without the need for anesthesia.
• Most report a positive experience and appreciate the non-invasive nature of the treatment.

By providing this level of detail, patients can better understand what to expect before, during, and after PTNS, allowing them to make informed decisions about their health care options.