Percutaneous tibial nerve stimulation (PTNS) is a non-invasive treatment for overactive bladder (OAB). PTNS involves peripheral neuromodulation that uses electrical stimulation to target the spinal cord roots, mainly S3, which controls bladder function. Neuromodulation is postulated to be the effect of cross-signaling between sympathetic and parasympathetic post ganglionic nerve terminals and synapses, causing alteration of nerve signals involved in the voiding reflex. de Groat, et al. described this neurophysiological process and the neural circuits involved in controlling the lower urinary tract [1]. Stimulation of peripheral nerves and subsequent “cross-talk” at the level of the postganglionic neuroeffector junctions can modulate transmission and facilitate detrusor inhibition [2].
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