CANDIDATES FOR THERAPY Percutaneous Tibial Neuromodulation (PTNM)

An Alternative to Medication

For some overactive bladder (OAB) patients, pharmacology is adequate. However, as many as 7 in 10 patients give up taking medication within 6 months.1,2 Patient compliance with medications such as anticholinergics is low due to variable efficacy and side effects, such as dry mouth and constipation.3

Percutaneous tibial neuromodulation (PTNM) delivered by the NURO™ system is an effective alternative treatment option for patients who may not be a suitable candidate for OAB medications or are reluctant to try medication. Drug-naïve OAB patients treated with NURO PTNM therapy experience a nearly 70% reduction in urgency urinary incontinence episodes (UUIE).4

PTNM is also an alternative for patients whose symptoms have previously failed to respond to medications, but who are not a good candidate for sacral neuromodulation therapy.

Treatment Options for Overactive Bladder

PTNM, delivered by the Medtronic NURO™ System, expands your treatment options for OAB patients who:

  • Have overactive bladder with symptoms of urinary urgency, urinary frequency, or urge incontinence
  • Are seeking an alternative to oral medications
  • Prefer an office-based treatment
  • Are not a candidate for sacral neuromodulation (SNM)
  • Need a lower-body MRI
  • Are unwilling or unable to tolerate the potential need for self-catheterization

Third-line OAB treatment options include:3

  • PTNM — a periodic office-based procedure that requires no drugs or surgery
  • Sacral Neuromodulation — continuous bladder control with the implanted InterStim™ system (see Indications, Safety, and Warnings)
  • Intradetrusor Onabotulinum toxin A (BOTOX®) — a periodic office-based procedure

BOTOX® is a registered trademark of Allergan, Inc.

Most common side effects of PTNM are temporary and include mild pain or skin inflammation at or near the stimulation site.

Patient Materials for OAB

pdf Weekly Bladder Symptom Diary (.pdf)

Symptom tracking chart for OAB patients to use for recording their symptoms.

pdf PTNM Guidebook  (.pdf)

A guidebook for getting results with percutaneous tibial neuromodulation delivered by the NURO system.



Haab, F. and D. Castro-Diaz (2005). Persistence with antimuscarinic therapy in patients with overactive bladder. Int J Clin Pract 59(8): 931-937.


Yeaw, J., J. S. Benner, et al. (2009). Comparing adherence and persistence across 6 chronic medication classes. J Manag Care Pharm 15(9): 728-740.


Gormley, E. A., D. J. Lightner, et al. (2015). Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 193(5): 1572-1580.


Kobashi K, Khandwala S, MacDiarmid S, et al. A Prospective Study to Evaluate Efficacy with the NURO Percutaneous Tibial Neuromodulation System in Drug Naïve Patients with overactive bladder syndrome (OAB). Presented at the American Urological Association 2018 Annual Meeting. Journal of Urology. 2018;199(4) Supplement, Page e987.