How it works
The tibial nerve runs near the inner ankle and shares nerve pathways with the nerves that control the bladder. Gentle electrical stimulation of this nerve can calm bladder signals and reduce urgency, frequency and urge leakage. It is a recommended option for people whose overactive bladder (OAB) has not improved enough with lifestyle changes or medications, or who cannot tolerate medications.
Percutaneous tibial nerve stimulation (PTNS)
With PTNS, a very thin needle is placed near the ankle and connected to a small stimulator for about 30 minutes. Treatment usually starts with 12 weekly office sessions, followed by periodic maintenance sessions for people who respond. No anesthesia is needed, and patients can drive home and return to normal activity right away.
Implantable tibial stimulation
For people who respond but prefer not to come in weekly, small implantable tibial nerve stimulators are now FDA-approved. A coin-sized or slim device is placed under the skin near the ankle in a short procedure, usually with local anesthesia, and delivers therapy automatically. Dr. Neal Patel can review which implant options are appropriate for you.
How it fits with other OAB treatments
Tibial stimulation is one of several advanced therapies for OAB, along with bladder Botox injections and sacral neuromodulation. The right choice depends on your symptoms, other health conditions, preferences and how much maintenance you want. Advanced Urology is recognized as a Medtronic World Center of Excellence on Advanced Overactive Bladder Therapies. Learn more on the overactive bladder & incontinence page.
Next step
Call 678-344-8900. Same-day and next-day appointments are often available.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Appointments are available at the Johns Creek, Cumming, Decatur and Braselton offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.