Status of Tibial Nerve Stimulation for Overactive Bladder

Overactive bladder is a significant health problem for individuals of all ages. Posterior tibial nerve stimulation for overactive bladder is not a new concept, but providers and some third party payers have been slow to embrace it. Until recently, lack of level 1 evidence had raised questions as to its efficacy and duration of benefit. Level 1 evidence now exists to support its use for the treatment of overactive bladder. However, questions remain as to the durability of the benefit. It is likely that chronic maintenance therapy will be necessary in most cases. Emerging evidence may expand the indications for posterior tibial nerve stimulation to include multiple sclerosis, Parkinson’s disease, childhood voiding dysfunction, fecal incontinence, interstitial cystitis, and chronic prostatitis. New methods for stimulating this nerve without needles may someday replace current techniques.