I have an overactive bladder for which treatment using the drug Oxybutynin and general bladder training therapies have had limited success. My MS nurse has suggested percutaneous posterior tibial nerve stimulation (PTNS) could be a possible solution. Can you tell me more about this treatment, its safety and effectiveness?

Percutaneous posterior tibial nerve stimulation (PTNS)  is a therapy that is relatively new to the NHS and is used to counteract the symptoms of an overactive bladder. The procedure involves inserting a needle close to a nerve which is situated just above the ankle, with an electrode being placed on the foot. Once these are in place a mild electric current is passed through the needle and is then directed to the nerves that are responsible for controlling bladder function. These nerves are situated in the lower back. This treatment is administered via 12 outpatient sessions, once per week, with each session lasting approximately 30 minutes.

The National Institute for Clinical Excellence’s (NICE) patient guide for PTNS confirms that is a reasonably safe and effective way to treat an overactive bladder, particularly if first line treatments such as medication, bladder training and pelvic muscle training have not had the desired effect. Moreover, studies have shown that PTNS treatment is effective in treating people with MS who are affected by overactive bladder issues.

Given that this treatment is relatively new, more evidence is being gathered regarding its effectiveness in the long-term. It may follow that one day, PTNS treatment becomes part of the first line solutions offered to counter bladder symptoms. What we do know so far is that for many, it has provided a welcome relief from the discomfort that accompanies an overactive bladder.

To find out more about the PTNS procedure, including evidence of its efficacy and safety, go to the NICE website – nice.org.uk/guidance/ipg362