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Percutaneous Tibial Nerve Stimulation — Office-Based Devices

This is the device / hardware index for office-based percutaneous tibial nerve stimulation (PTNS). For mechanism, technique, full efficacy data (SUmiT sham-RCT, meta-analyses, comparators vs antimuscarinics / SNM / OnaBT), fecal-incontinence evidence (CONFIDeNT, NOTABLE), safety, contraindications, and TTNS, see the canonical clinical page: Percutaneous Tibial Nerve Stimulation (procedure).

At a Glance​

  • Indication: refractory OAB / UUI — third-line per AUA/SUFU 2024 alongside SNM and intradetrusor OnaBT; first-line option in EAU female-LUTS evidence.
  • Treatment course: 30-min session weekly × 12 weeks (induction) then maintenance every 2–3 weeks indefinitely.
  • Device class: external pulse generator + single-use needle electrode kit. No implant.
  • Clinical effect persists only with ongoing sessions — the maintenance-visit burden is the principal limitation, driving the development of implantable tibial systems.

Available Devices​

Urgent PC Neuromodulation System​

  • Originally Uroplasty / Cogentix Medical, now Laborie.
  • Battery-powered external stimulator + fine percutaneous needle electrode + surface ground electrode.
  • First commercially widespread PTNS system (FDA-cleared 2005).
  • Still the most commonly used PTNS device globally.

NURO System (Medtronic)​

  • Medtronic's office-based PTNS equivalent.
  • Single-use kits with needle, electrode, and stimulation cables.
  • Same fundamental concept and technique as Urgent PC.

Stimulation Parameters (Both Devices)​

  • 34-G stainless steel needle inserted 5 cm cephalad to the medial malleolus, posterior to the tibia, ~60° angle.
  • Surface electrode on the ipsilateral calcaneus.
  • Frequency 20 Hz, pulse width 200 μs, current 0.5–9 mA titrated to a sensory or motor response (great-toe flexion / tingling in the sole).
  • 30-minute session.

Relationship to Implantable Tibial Systems (ITNS)​

The maintenance-visit burden of PTNS drove the development of fully implantable tibial neuromodulators — see eCoin, Revi, and Altaviva. All three deliver the same neuromodulation principle (tibial-nerve afferent activation of the S2–S4 plexus) without weekly clinic visits. The Amundsen 2025 SR/meta-analysis found comparable responder rates between SNM and implantable tibial neuromodulation (~72–80%) — emerging evidence that the implantable tibial route may match SNM efficacy without a trial-phase requirement.

Transcutaneous Alternative (TTNS)​

Same mechanism with surface electrodes rather than a needle — can be performed at home. Meta-analyses suggest comparable efficacy to PTNS for voiding frequency, especially in neurological patients for whom repeated office visits are difficult. Detail on the PTNS procedure page.

See also: PTNS (procedure), eCoin, Revi System, Altaviva, Medtronic InterStim, Axonics SNM.