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Nerve treatment may help overactive bladder

September 6, 2010 12:00:00 AM PDT
Not too many people want to talk about it, but it's a problem that impacts about 30 million Americans. Overactive bladder disrupts lives and can make people prisoners in their own homes.Drugs can help, but doctors say up to 80 percent of people quit taking them because of side effects or because they don't work.

So, could a little zap to the ankle be a drug-free solution for overactive bladder?

For 20 years, Linda Krogstad tried to work in her garden, but Mother Nature always interrupted - sometimes up to 20 times per day.

"And I'd have no control over it," said Krogstad. "I've tried everything."

Her overactive bladder was holding her hostage.

"Pretty much just stayed around the house," said Krogstad.

Drugs, physical therapy and surgery didn't work, so she tried something new called percutaneous tibial nerve stimulation, also known as PTNS.

"We're trying to target the nerve that's coming down the leg, called the tibial nerve," described Dr. Suzette E. Sutherland, a urologist with the Centers for Continence Care and Female Urology in Minnesota.

Urologists insert a small needle near the ankle and attach a device that sends electrical pulses up the leg to the sacral plexus, a major nerve superhighway in the pelvis that controls the bladder.

"It sort of changes the way the nerves are perceiving what's going on in the pelvic area just to try to get all that messaging and information to calm down," explained Sutherland.

Patients sit while the device stimulates the nerve for 30 minutes, two to four times a month for three months. The treatment lasts for about a month, and then the routine is repeated.

Recent studies found PTNS worked as well as meds without side effects with 55 percent of patients in one trial reporting significant improvement.

The problem is cost, because it's not always covered by insurance, and it can run $200 a session which adds up to $1,000 a month.

"I liked that I can go in every two weeks, and I didn't have to have anything put into my body," said Krogstad, who says now she can set her own schedule.

"It's just nice to be able to be outside and not have to run to the bathroom all the time," she said.

PTNS is FDA approved to treat symptoms of overactive bladder. Another study published in the Journal of Urology found the therapeutic effect of PTNS is not the result of a placebo effect and that stimulation of the nerve resulted in true improvement.


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