Transcutaneous Tibial Nerve Stimulation (TTNS) is a non-invasive treatment option for managing overactive bladder (OAB). It involves the stimulation of the tibial nerve, which is located near the ankle, to help modulate the neural pathways that influence bladder function.
How TTNS Works
Tibial Nerve Pathway: The tibial nerve is a branch of the sciatic nerve and is connected to the sacral nerves, which control the bladder and pelvic floor muscles. By stimulating the tibial nerve, the treatment aims to influence the sacral nerves indirectly, thereby helping to control bladder function.
Electrical Stimulation: In TTNS, small electrodes are placed on the skin near the ankle, where the tibial nerve is located. A mild electrical current is delivered through these electrodes, which stimulates the nerve.
Treatment Sessions: Typically, TTNS is self-administered at home for up to one hour per session, either daily or at least three times per week. The initial trial period usually lasts for six weeks, though the exact regimen may be adjusted based on the patient’s response. If effective, the treatment may be continued long-term to maintain symptom relief.
Mechanism of Action
The exact mechanism of how TTNS helps in helping bladder symptoms is not fully understood. It is believed that the electrical stimulation modulates the reflexes between the bladder and the spinal cord, leading to reduced bladder overactivity. This can reduce day time and night time frequency, urinary urgency, as well as reduce episodes of leakage or urge incontinence.
Benefits and Efficacy
Non-invasive: Unlike some other bladder treatments, TTNS does not require surgery or internal devices. It is done externally, making it a relatively low-risk option.
Symptom Relief: Studies have shown that TTNS can be effective in reducing the symptoms of OAB, such as frequency, urgency, night voids (nocturia) and incontinence.
Few Side Effects: TTNS is generally well-tolerated with minimal side effects.
Affordable: Home units can be purchased for less than $100.
Limitations
Variable Response: Not all patients experience significant symptom relief, and the degree of improvement can vary.
Ongoing Treatment: Some patients may need to continue treatment for ongoing improvements, which could be a long-term commitment.
TTNS is a great treatment option for patients with bladder frequency, nocturia (waking at night to void) and urgency, particularly those who prefer a non-invasive approach or who have not responded well to other treatments.
A pelvic floor physiotherapist can provide you with a home TTNS unit and instructions on how to use it, allowing you to continue the therapy at home. Additionally a pelvic floor physiotherapist can provide fluid and bladder care advice and teach you exercises to strengthen your pelvic floor muscles, which can enhance the effectiveness of TTNS. This combination of physiotherapy and TTNS can offer a more comprehensive approach to managing your bladder symptoms.
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