An Important Question Not Yet Answered
What We Know
- Tibial nerve stimulation (PTNS, TTNS, Vivally, and Revi) has been shown to reduce OAB symptoms in many patients.
- During a treatment session, stimulation often becomes more comfortable. Some patients increase the intensity to maintain clearly noticeable but comfortable stimulation.
- Purpose-designed OAB systems (PTNS, Vivally, and Revi) operate within manufacturer-defined stimulation limits established during product development and clinical evaluation.
- A general-purpose TENS device used for TTNS can provide substantially higher stimulation intensity.
Hypothesis (What We Suspect)
- Some patients, including the author, have observed that increasing stimulation intensity may extend the period of symptom relief and reduce the frequency of maintenance treatments.
- That could explain why some patients gradually increase the intensity over months or years.
What We Do Not Know
- We do not know whether repeated, long-term use of stimulation substantially above the levels used in purpose-designed OAB systems provides greater long-term benefit, increases long-term risk, both, or neither.
- We have not identified long-term studies designed to answer this question.
Why Might This Question Remain Unanswered?
- Answering this question is likely to require a costly, long-term study involving many patients over many years.
- The results would benefit patients, physicians, researchers, and every manufacturer of tibial nerve stimulation systems—not just one company.
- Because the knowledge would become a public benefit rather than a competitive advantage, it may be difficult for any single manufacturer to justify funding such a study.
Remember
- A knowledge-based decision considers both what we know and what we do not yet know.
- If you choose to increase stimulation intensity, do so thoughtfully.
- The goal is effective, comfortable, and consistent stimulation—not simply the highest tolerable intensity.
- Report persistent pain, numbness, burning, or other unexpected effects to your physician.
Session Tracking and Feedback — How You Can Help
You may remember the Tracking Sheet and Completion Questionnaire (TSCQ) introduced in the Roadmap. That form can be used to track and evaluate any OAB therapy trial.
We have developed a unique TSCQ specifically for TTNS trials. It tracks not only your symptoms, but also TTNS treatment details that may help you and your physician understand your results.
You know that therapy trials may last weeks or months. During that time, symptoms may improve, worsen, or change; side effects or other events may occur; and some changes may have causes unrelated to the therapy. It can be difficult to remember later exactly what happened and when. Keeping a written record can help. If you record what you observe, when it happens, you and your physician can consider later whether an observation may be related to the therapy or to something else.
If you choose to share your Tracking Sheet and Completion Questionnaire (TSCQ),
- Your experience may help improve understanding of the range of patient responses ultimately and benefit others exploring TTNS.
- Tracking your progress and sharing your experience are entirely voluntary.
- If you decide on a TTNS trial, please mail us your completed TSCQ after your evaluation period. You may send the original or a copy, with or without identifying information, to OAB Therapy 101, P.O. Box 211, Novi, MI 48376.
- If you include optional contact information, you permit OAB Therapy 101 to contact you about your report.
Download:
TNS Tracking Sheet & Completion Questionnaire (TSCQ):
Two Ways to Obtain a TTNS Template—
If You Decide to Use One
If you want to make your own template, download the PDF containing patterns and instructions:
Alternatively, if you decide to try TTNS and prefer not to make your own template, send a #10 self-addressed, stamped envelope with a waiver (Download, Print, Read, and Sign the Waiver (PDF)) to the address below, and OAB Therapy 101 will mail you a template.