6.4: Posterior Tibial Nerve Stimulation

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Because of the technical and cost implications of SNS, indirect neuromodulation of S2,3 and 4 via stimulation of the posterior tibial nerve, was developed. The technique is performed by passing an electric current between a small acupuncture needle 4cm above the medial malleoulus and an electrode on the sole of the patient’s foot. The device has only recently become available and marketed by Manta Surgical under the name of “Urgent PC” in South Africa. There is a significant disposable component to the equipment, including a single use electrode and needle and this unfortunately drives up the cost of using this device. The treatment regime consists of up to 12 weekly sessions of 30 minutes although it may be efficacious after shorter treatment periods, it does not last indefinitely and it needs to be repeated after a few months.
It has been shown to be efficacious in two trials with one reporting more than 50% reduction in leakage episodes in 70% of their cohort, 46% of the subjects reporting being dry. 71% of the cohort of 53 patients in another trial reported treatment success.