For those of you familiar with the song “Dry Bones” by the Delta Rhythm Boys, this may sound pretty funny! After all, the song never mentions the bladder. In fact, the song is all about bones and has lyrics more like this:
“Well, your toe bone connected to your foot bone
Your foot bone connected to your heel bone
Your heel bone connected to your ankle bone
Your ankle bone connected to your leg bone
Your leg bone connected to your knee bone
Your knee bone connected to your thigh bone
Your thigh bone connected to your hip bone
Your hip bone connected to your back bone”
You’ll notice that this song is all about bones … not a single mention of the bladder at all. But for women with urinary incontinence, you could say that the ankle bone is connected (sort of) to the bladder. Really!
Women’s Urinary Incontinence: The Ankle Bone and the Bladder
By now you are probably wondering what we’re talking about when we connect the ankle bone to the bladder. It turns out that there is a nerve in your body, called the percutaneous tibial nerve, that is located just above your ankle bone. This nerve is part of the nervous system that controls the action of your bladder. By using a therapy called percutaneous tibial nerve stimulation, which sends a gentle electrical current into the nerve, doctors have been able to alleviate symptoms for women with overactive bladder or urge urinary incontinence.
More About Percutaneous Tibial Nerve Stimulation
This conservative therapy is a wonderful option for women with overactive bladder or urge incontinence, especially those women who have not had much luck with behavior modification or drug therapy. Usually performed by a urologist, this therapy can also be delivered by nurses or physician assistants who have received the appropriate training.
For the procedure, your doctor will have you elevate your leg while in a sitting position. A very fine needle is then inserted just above the ankle bone into the percutaneous tibial nerve. A mild electric current is delivered via this needle for 30 to 60 minutes per session. Don’t be surprised if your toes or foot flex gently during the treatment as this is perfectly normal. You may also feel a mild tingling sensation in your foot or around your ankle. Most doctors recommend four treatments per week, with the total therapy lasting between eight and twelve weeks.
Two studies (the OrBIT trial and the SUMiT trial) have shown that tibial nerve stimulation is effective in decreasing the frequency of urination by 20% in women who need to urinate at least eight times every 24 hours. In addition, women report a 36% reduction of the severity of their symptoms, as well as a 34% improvement in the quality of life. Other improvements as a result of this therapy include reductions in urinary leakage accidents, frequency, and urge. Those are pretty solid success rates, so if you have overactive bladder or urge incontinence, you may want to ask your doctor about this form of therapy.
So you see? The ankle bone is indeed connected to the bladder!
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