Neuromodulation for Male Urinary Dysfunction

Percutaneous tibial nerve stimulation involves applying gentle electrical stimulation to the tibial nerve, which spans from the foot to the spine, improving bladder function and reducing how often you urinate and get up in the night with urgency incontinence. 

Your NYU Langone urologist inserts a needle that is very fine, similar to those used in acupuncture, near the ankle. The needle is actually an electrode that delivers low-voltage electrical impulses through a nerve in the leg up to nerves that control the bladder muscle. 

The procedure lasts 30 minutes and is performed once a week for 12 weeks in the doctor’s office. Follow-up treatments range from every few weeks to every few months.

If other treatments fail or cannot be tolerated, your doctor may recommend sacral neuromodulation. This therapy involves using mild electrical pulses to stimulate the sacral nerves, pairs of nerves in the lower back that control the bladder and other pelvic organs. 

The doctor first tests the nerve to see whether it helps improve your urinary symptoms. If this three-day trial is successful, a small pacemaker-like device is implanted in the fleshy part of the buttocks. A thin wire extends from the device to the area near the sacral nerve, to which low-voltage pulses are delivered. This helps reduce symptoms of urgency incontinence and may help some men with neurogenic voiding dysfunction. 

The device is implanted at the hospital using a light anesthesia; the device’s battery lasts about five years. You need surgery to replace the battery or implant a new device.