Percutaneous Tibial Nerve Neuromodulation (UrgentPC or NURO) in New York City for Treatment of OAB and Frequent Urination in Men and Women.

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4151

We offer affordable, highest-quality urology care.  We offer weekday, weekend, and evening office hours. 

Experienced Urologists at New York Urology Specialists are at the forefront of innovative science that changes people’s lives.  We have extensive experience in treatment of men and women with symptoms of OAB, urinary frequency and urgency.  We are one of few centers in New York area that offers safe and effective treatment with posterior tibial neuromodulation in our Manhattan office. 

What is Percutaneous Tibial Nerve Neuromodulation?

Percutaneous tibial nerve neuromodulation (PTNM or PTNS) is an innovative treatment option for men and women who suffer from overactive bladder, frequent urination, urinary urgency, and urinary urge incontinence.  Percutaneous tibial nerve neuromodulation has been shown to be as effective as medical therapy with medication such as Vesicare and oxybutynin but with fewer side effects and complications. 

Studies show that when PTNS is added to medications, the benefit is greater than using medications alone or PTNS alone.  There are two neuromodulation devices available in the US:  Nuro neuromodulation system and UrgentPC, which have similar efficacy in treatment symptoms of OAB, urgency and urge incontinence.

How is Percutaneous Tibial Nerve Neuromodulation Performed?

Percutaneous Tibial Nerve Neuromodulation treatment involves using tiny acupuncture-like needles in the foot to deliver light stimulation to the tibial nerve for 30 minutes a week.  The initial ‘induction’ course of treatment is performed once a week for 12 weeks.  For patients who experience benefit from the 12-week course, maintenance therapy is administered once a month.  Overall, more than 60% of patients experience improvement in symptoms.  If you ever had acupuncture, that’s exactly what you would to expect – minimal discomfort.  There are no long-term side effects as you get from medications.

Who is a Good Candidate for Percutaneous Tibial Nerve Neuromodulation with UrgentPC?

Men and women who experience symptoms of overactive bladder (urinary frequency, urgency), urinary urge incontinence and who cannot tolerate medications or unwilling to take medications are good candidates for UrgentPC tibial neuromodulation therapy.  Patients who are taking oral medications such as Vesicare, Myrbetriq, oxybutynin may experience a further benefit by incorporating tibial neuromodulation in their treatment.  Tibial nerve neuromodulation works synergistically with medications to treat urinary frequency, urgency, and incontinence.

What does Percutaneous Tibial Nerve Neuromodulation do?

PTNS stimulates tibial nerve which in turn stimulates and induces the pelvic nerves that control bladder function to ‘re-learn’ correct function.  Neuromodulation therapy ‘re-trains’ the nerves that control urinary bladder function to reset and relearn correct behavior.

Is Percutaneous Tibial Nerve Neuromodulation Safe?

Percutaneous tibial nerve neuromodulation is an extremely safe treatment option for patient’s with overactive bladder, neurogenic bladder, frequent urination, and urinary urgency and urinary incontinence.  Studies showed no significant side effects other than transitory discomfort of needle stimulating the tibial nerve during the procedure.  Thousands of patients have been treated safely worldwide. PTNS is FDA approved.  Multiple randomized controlled studies support its effectiveness and safety.

Is PTNS Covered by Health Insurance?

Most health insurances cover treatment with Percutaneous Tibial Nerve Neuromodulation for treatment of frequent urination, urinary incontinence, and overactive bladder when patients cannot tolerate medical therapy or failed medical therapy.

How Effective is Percutaneous Tibial Nerve Neuromodulation for Treatment of Urinary Incontinence?

PTNS is as effective as medical therapy with medications such as Detrol, tolterodine, oxybutynin, Vesicare in the treatment of symptoms of urge urinary incontinence.  Percutaneous tibial nerve neuromodulation is associated with fewer side effects than medications.

PTNS treatment has been shown to be effective for as long as 3 years with maintenance monthly therapy.  Typical findings show significant improvement in the number of urinary episodes per day by 30% from 12 to 8.5; improvement in urge incontinence episodes from 3.3/day to less than 1 in 3 days and improvement in episodes of urination at night by 50% (from an average of 2.7 to 1.7).

In Sumit trial of PTNS vs sham control (J. Urology 2010), 54% of patients treated with PTNS experienced moderate or marked improvement in symptoms compared to only 21% of sham subjects.   This study showed improvements in frequency of urination including improvement in frequency of urination at night; improvement in urgency and urinary urge incontinence episodes.

Typically patients experience benefit after 8-10 weeks of treatment.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4151

Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men and women with urinary problems including frequent urination, difficulty emptying the bladder, urinary urgency and incontinence.