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Percutaneous Tibial Nerve Stimulation — Office-Based Devices

This page covers PTNS hardware and treatment burden. For patient assessment, insertion technique and clinical alternatives, see PTNS procedure.

Available Systems​

SystemHardware
Urgent PC — LaborieExternal stimulator with a percutaneous needle electrode and surface electrode
NURO — MedtronicExternal stimulation system with its compatible single-use needle/electrode kit

Both deliver tibial stimulation without an implant. Use the exact system's instructions for electrode placement, connections and programming; a published protocol does not establish identical hardware or settings for every product.[1][2]

Course and Evidence​

A commonly studied induction course is 30 minutes weekly for 12 weeks. In the 220-participant SUmiT sham-controlled trial, 54.5% versus 20.9% reported moderately or markedly improved overall bladder symptoms at 13 weeks. This is a global-improvement outcome, not a percentage of patients made dry.[3]

Maintenance is individualized. STEP enrolled 50 initial SUmiT responders, of whom 29 completed three years; after a taper, the median maintenance frequency was 1.1 treatments per month. This selected-responder study does not establish a fixed interval or durable response for everyone starting PTNS. Discuss ongoing visits, reassessment and the possibility of symptom recurrence.[4]

Eligibility and Precautions​

US manufacturer summaries describe OAB-associated urgency, frequency and urge incontinence. They list contraindications including pacemakers/implantable defibrillators, excessive bleeding risk, relevant nerve damage, and pregnancy or planned pregnancy. Avoid treatment through compromised skin and consult the full device instructions. Minor insertion-site bleeding, discomfort and inflammation can occur.[1][2]

The 2024 AUA/SUFU guideline allows shared decisions about minimally invasive therapies without mandatory preceding treatment trials. Statement 25 specifically recommends offering percutaneous tibial stimulation, SNM and/or intradetrusor botulinum toxin after inadequate response or intolerance to behavioral therapy or medication. A rigid “third-line only” description no longer reflects that framework.[5]

Implants and Surface-Electrode Therapy​

eCoin, Revi and Altaviva reduce repeat office stimulation visits but introduce implantation, maintenance and device-specific safety requirements. The AUA 2024 implantable-device section does not transfer the PTNS recommendation to these systems.[5]

TTNS uses surface electrodes and can support a home protocol. Its device, regimen, population and evidence differ from percutaneous and implanted stimulation; a shared target nerve does not establish interchangeable efficacy. See the procedure hub for that comparison.

References​

1. Laborie. My PTNS Program. Current Urgent PC manufacturer information and US safety footer. Manufacturer resource.

2. Medtronic. Percutaneous Tibial Neuromodulation: Indications, Safety and Warnings. Current NURO manufacturer summary. Safety information.

3. Peters KM, Carrico DJ, Perez-Marrero RA, et al. Randomized Trial of Percutaneous Tibial Nerve Stimulation Versus Sham Efficacy in the Treatment of Overactive Bladder Syndrome: Results From the SUmiT Trial. J Urol. 2010;183:1438–1443. doi:10.1016/j.juro.2009.12.036.

4. Peters KM, Carrico DJ, Wooldridge LS, et al. Percutaneous Tibial Nerve Stimulation for the Long-Term Treatment of Overactive Bladder: 3-Year Results of the STEP Study. J Urol. 2013;189:2194–2201. doi:10.1016/j.juro.2012.11.175.

5. AUA/SUFU. Idiopathic Overactive Bladder Guideline, 2024. Statements 23–25 and implantable-tibial-stimulation discussion, pp 30–32. Unabridged guideline.