It uses a mild electric current to treat your overactive bladder (OAB) and ease your strong urge to pee.
Electrical stimulation may give you better control over the muscles in your bladder, a sac-shaped organ that holds your urine. Your doctor may recommend it if medicine, pelvic exercise, and other lifestyle changes haven’t worked for you.
How It Works
Your doctor has three ways to deliver the electrical current. One requires surgery.
Sacral nerve stimulation (SNS). During this operation, your doctor puts a pacemaker-like device in your back at the base of your spine. That’s the site of your sacral nerve, which carries signals between your bladder, spinal cord, and brain that tell you when you need to urinate. SNS interrupts those signals.
Usually before the operation, you’ll test the treatment to see if it works for you. Your doctor will make a small cut in your lower back and put a thin wire close to your sacral nerve. The wire connects to a battery-powered device called a stimulator that you wear outside your body. You’ll have it for up to 3 weeks.
If your symptoms get better, you'll have surgery to put in the device permanently. For that, you'll be put to sleep with moderate sedation (formerly called "conscious sedation"). After the operation, you'll be able to adjust the level of stimulation with a hand-held programmer. You might not be a good candidate for this surgery if you have a nervous system disease like multiple sclerosis. It’s also unclear if this procedure is safe for pregnant women or children. However, clinical trials and studies are ongoing in this population.
SNS can cause side effects, including:
- Pain
- Wire movement
- Infection
- Temporary electric shock-like feeling
- Bleeding at implant site
The device may also stop working. Up to 2/3 of people who have SNS will need another surgery within 5 years to fix the implant or to replace the battery.
Percutaneous tibial nerve stimulation (PTNS). This treatment isn’t surgery. Your doctor inserts a thin needle under the skin of your ankle near the tibial nerve.
A stimulator on the outside of your body sends electrical impulses through the needle to the nerve, and on to other nerves in your spine that control your bladder.
Each PTNS treatment takes about 30 minutes. Usually, you'll have 12 sessions, once a week. You might need more sessions to keep seeing results.
Not everyone is a good fit for PTNS. You might not be able to use this device if you:
- Have a pacemaker or implantable defibrillator
- Have a high chance of bleeding
- Have nerve damage that affects your tibial nerve or pelvic organs
- Are pregnant or plan to get pregnant during treatment
- Have severe lower extremity edema or swelling
Side effects from PTNS are rare, and they're usually minor. They include:
- Bruises or bleeding where the needle is inserted
- Tingling or mild pain
Transcutaneous electrical nerve stimulation (TENS). This procedure strengthens the muscles that control urination. Your doctor places thin wires inside your vagina, if you’re female, or in your bottom, if you’re male. It delivers pulses of electricity that stimulate your bladder muscles to make them stronger.
eCoin Tibial Neurostimulator. The battery-powered eCoin device, about the shape and size of a nickel, is implanted near the ankle. ike PTNS, eCoin stimulates the tibial nerve — but it does so automatically. The procedures is typically done in a doctor's office. The battery can last for up to 7 years.
How Well Does It Work?
Studies show that electrical stimulation works better than fake stimulation (placebo) or Kegel exercises to relieve OAB symptoms. It's not clear whether one type of stimulation works better or is safer than another.
What to Expect
It might take some trial and error to find the right treatment for your OAB. Talk to your doctors about the pros and cons of electrical stimulation. You might ask:
- Which of these treatments do you recommend?
- How is it different from other electrical stimulation treatments?
- What side effects can it cause?
- What should I do if I have side effects?
If the electrical stimulation doesn’t work for you, talk to your doctor about other possible options.