Magazine and Regain Urinary Continence
Marja Sprock, M.D. FACOG, FPMRS board
It sounds like another scam but do not stop reading
yet. One of the tertiary treatments for overactive
bladder (OAB) is called Percutaneous Tibial Nerve
Stimulation (PTNS) and is administered while you are
seated, with just your bare ankle showing.
You may not be aware that the tibial nerve, which
runs close to your ankle, has a connection with the
sacral plexus, which innervates the bladder. While you
are reading your ankle will receive a non-painful
stimulation of the nerve with the documented potential
to improve OAB in about 70 to 80% of people.
One of the tertiary
treatments for overactive bladder
(OAB) is called Percutaneous Tibial
Nerve Stimulation (PTNS) and is
administered while you sit down,
with just your bare ankle showing.
The standard protocol is 12 treatments of 30 minutes
each. An evaluation of effectiveness is usually made
after 6 sessions, making sure you are benefitting from
the treatment. After the 12 treatments, the stimulation
can be continued on a less frequent basis.
So what does that mean in real life? Well, meet
Grace, age 64, who has tried several medications for
OAB. She used to be able to hold her urine for hours. As
a nurse she often skipped her bathroom breaks. Grace
started having gradually worsening leakage of urine. She
had seen her mother go through that and did not want to
end up in diapers. Grace is very active in the community
and likes taking her grandchildren places. Grace made
sure she emptied on a regular basis, urge or no urge, 3
hours was her maximum during the day. She had always
been good at contracting her pelvic floor muscles and
keeping them strong. In other words the first steps of
treating OAB had been implemented already.
Grace had tried anticholinergic medications which
worked well for some of her patients, but she could not
tolerate the side-effects. Anticholinergics are
medications used for OAB, very effective and a
life-saver for some people, but as always not for all.
Reviewing her options: sitting in a chair with weekly
visits and a good chance for improvement, injections
with Botox® in the bladder or a more permanent nerve
stimulator (Interstim®), Grace chose the comfortable
chair treatment. After 12 PTNS treatments which have
helped Grace out of her pads, she is now on a
maintenance treatment. She had a treatment 1 month ago
and continues to do well.
During the PTNS treatment an extremely small needle
electrode is used to stimulate the tibial nerve just
above the ankle, which connects to the nerve innervating
the bladder. After several 30 minute treatments symptoms
of urinary urgency, frequency and urge incontinence may
disappear or improve. The risks are low and limited to
infrequent mild pain or skin inflammation near the
ankle. PTNS is not a new treatment. It has been
extensively studied worldwide for 15 years.
PTNS is another option available to treat OAB. Even
though it is administered while you relax in the office
for 30 minutes and read, we still do expect you to walk
your mile a day. It can’t all be that easy!
For information on some of the equipment we use to
treat overactive bladder and associated symptoms of
urinary urgency, urinary frequency and urge
incontinence, check out the
Marja Sprock, MD at Central Florida UroGynecology in
Rockledge, is board certified in OB/GYN as well as FPMRS
(Urogynecology). She is the go-to-person for
urinary and or fecal problems as well as prolapse
Call Central Florida
UroGynecology in Rockledge 321-806-3929 or visit
www.CFUroGyn.com for more information.
Florida UroGynecology where high tech and common sense