• Transcutaneous Tibial Nerve Stimulation (TTNS) is one member of the Tibial Nerve Stimulation (TNS) family of therapies.

• Outside the United States, TTNS has been studied and used extensively to treat overactive bladder symptoms.

•In the United States, however, TTNS using general-purpose TENS devices has not been cleared by the FDA for treatment of OAB symptoms and remains unfamiliar to many physicians and patients.

• As a result, patients who wish to make knowledge-based decisions may discover that relatively little practical information about TTNS is available from traditional U.S. sources.

Our Working Hypothesis

• OAB Therapy 101 believes that one plausible explanation for TTNS’s limited use in the United States is that treatment efficacy may depend partly on the patient placing the surface electrodes correctly and

consistently.

• This differs from PTNS, in which a trained clinician places the needle electrode using anatomical landmarks and evaluates the patient’s response, whereas TTNS requires the patient to position the surface electrodes repeatedly at home.

• We may prove to be correct, partly correct, or incorrect.

• As we gain experience with TTNS, our understanding may change.

Two Ways to Approach TTNS

If you and your physician conclude there are no contraindications to TNS, there are at least two ways to consider:

Approach 1 –

• Begin with FDA-cleared PTNS.

• If PTNS provides meaningful improvement, decide later whether changing to TTNS offers advantages for your situation.

Approach 2 -

• Learn about electrode placement, treatment technique, and tracking results

• Discuss TTNS directly with your physician.

•If TTNS fits your circumstances, decide whether to begin a TTNS trial.

Before Learning More About TTNS: