A bladder stimulator is a device that may help people with an overactive bladder or those unable to control their urge to urinate. The device can either go under the skin of the buttock or on the inside of the ankle.

Bladder stimulation can help with uncomfortable symptoms such as the inability to control urination.

People can choose between two procedures if they opt for bladder stimulation. However, it is important to discuss treatment options with a doctor, as they may not be safe for everyone, including those with certain medical conditions.

This article discusses bladder stimulation in more detail and the procedures that doctors may perform. It also looks at the procedure’s effectiveness, safety, and side effects.

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Bladder stimulation is a procedure that sends electric currents to the nerves and muscles to control urination.

It may be a suitable option for people who have an overactive bladder. Overactive bladder is when someone has the frequent urge to urinate but is difficult to control.

This condition can interfere with everyday tasks since people may require frequent bathroom visits. This can disrupt sleep cycles, and those who leak urine may also have a greater risk of developing infections.

Conditions that can cause an overactive bladder may include:

A 2019 review found that age and body mass index were risk factors for overactive bladder.

Learn more about overactive bladder.

There are two types of bladder stimulators that can help treat an overactive bladder.

Sacral neuromodulation or sacral nerve stimulation

Sacral nerve stimulation (SNS) involves a doctor placing a wire lead into the patient’s spine. This lead connects to a stimulation device that doctors place under the skin of the person’s buttock. The device then sends signals to the nerves that control the bladder.

People will also have access to an external controller to control the bladder stimulator’s levels.

Percutaneous tibial nerve stimulation

Percutaneous tibial nerve stimulation (PTNS) is another treatment option that does not require a surgical procedure.

PTNS has Food and Drug Administration (FDA) clearance to treat overactive bladder and the symptoms that come with urinary urgency, urinary frequency, and incontinence.

A PTNS session typically takes place in an office setting. A clinician places an acupuncture-like needle that attaches to an electrical device on the inside of the patient’s ankle. The healthcare professional then conducts a mild electrical stimulation through the needle for 30 minutes.

Learn more about PTNS.

One 2017 review concludes that PTNS is a noninvasive treatment that helps improve symptoms in about 60% of people. However, it notes the treatment is time-consuming.

A 2020 study suggests that SNS is a particularly effective treatment for overactive bladder in younger people, females, and individuals whose symptoms are nerve-related. However, researchers also note that it may not be as useful for older adults and those whose symptoms have no known cause.

There may be some side effects when undergoing SNS. The International Urogynecological Association (IUGA) mentions states they can include:

  • pain
  • skin irritation
  • infection
  • lead movement

People may also feel pain in their lower back, buttocks, and thighs. Some may also experience temporary weakness in their legs.

Complications from the procedure are also possible, including device problems, changes in bowel function, or unwanted sensations. In such cases, doctors may recommend removing the bladder stimulator.

Despite this, side effects from a PTNS session are typically mild and may include:

  • slight pain
  • bleeding at the needle site
  • minor irritation
  • redness
  • toe numbness
  • abdominal discomfort

The below sections describe what happens during an SNS and PTNS session:

SNS procedure

The SNS procedure involves two phases:

  • Testing: First, the doctor will check whether stimulation is effective in treating a person’s symptoms. To do this, they implant a wire under the skin and provide the person with an external device to control it. They can test the device for several days to see if it helps improve symptoms.
  • Implant phase: If there is noticeable improvement during the test period, a doctor may recommend permanent implantation. During the implant phase, the doctor will implant the wire in the lower back. The procedure is minimally-invasive and does not require an overnight stay in the hospital.

PTNS procedure

Unlike SNS, PTNS is a nonsurgical procedure that requires multiple in-person treatment sessions.

The procedure involves inserting a fine needle near the ankle that connects to a battery-powered stimulator. The device delivers electrical impulses to the nerves in the leg responsible for bladder control. Throughout the treatment, the doctor will adjust the intensity of the electrical impulse depending on how the person responds.

For most people, 30-minute sessions lasting 12 weeks are enough to help with symptoms. Following the initial treatment period, some individuals may need additional sessions at a lower frequency.

SNS and PTNS may not be safe for everyone.

The United Kingdom’s National Health Service (NHS) does not recommend SNS procedures to people who are pregnant or have spina bifida.

Additionally, PTNS sessions may not be suitable for individuals who:

  • have bleeding problems
  • have nerve damage
  • are pregnant

According to the IUGA, PTNS can be a suitable option when other treatment options, such as reducing caffeine intake, performing pelvic floor exercises, and taking medications, are ineffective.

Doctors may also recommend PTNS to people who are not suitable for SNS.

The IUGA also states that SNS is suitable for people with chronic urinary retention and overactive bladder. It may be beneficial to those who have experienced no improvement with medications and physiotherapy.

People with an overactive bladder may benefit from a bladder stimulator. This device controls the bladder and may reduce the need for frequent bathroom visits.

SNS and PTNS are two bladder stimulation procedures, but they may not be safe for individuals who are pregnant, have bleeding problems, or have nerve damage.

People interested in treatment for overactive bladder should talk with a doctor who can explain the procedure and discuss the potential risks.