UAB recently delivered its first implant of a new therapy for urge urinary incontinence (UUI) using a process called implantable tibial neuromodulation (ITNM), expanding treatment options for patients living with a condition that significantly affects quality of life but is frequently underreported and undertreated.
Tracey Wilson, M.D., FACSUUI is often associated with overactive bladder, a condition characterized by urinary urgency, frequent urination, and waking multiple times at night to empty the bladder. According to Tracey Wilson, M.D., FACS, professor in the UAB Department of Urology, overactive bladder affects an estimated 15 to 20 percent of adults, or nearly one in five people. UUI alone impacts approximately 7 to 10 percent of women and 3 to 5 percent of men, with prevalence increasing with age.
“However, urge urinary incontinence should not be considered a simple act of aging,” Wilson said. “Many believe that it is, and therefore, suffer in silence without seeking treatment. This leads to additional expenses, such as buying protective products like pads, as well as increased laundry and clothing costs. It can also interfere with intimacy and lead to isolation and depression.”
Wilson explained that treatment typically starts with behavioral changes, such as adjusting fluid intake, timing, and diet. Pelvic floor physical therapy, which focuses on strengthening pelvic muscles and learning urge‑suppression techniques, is another first‑line approach. Medications may also be prescribed for UUI, but side effects often limit long‑term use, with 62 to 88 percent of patients stopping medications within the first year.
For patients who do not respond to initial therapies, advanced nerve‑targeted treatments are available. These include botulinumtoxinA injections into the bladder muscle and in‑office nerve stimulation therapies such as posterior tibial nerve stimulation (PTNS), both of which can be effective but often require repeated treatments or frequent clinic visits. Other implantable neuromodulation options, such as sacral neuromodulation, offer effective symptom control but are not appropriate for all patients and may require device revisions over time.
“As you can see, more durable and patient-friendly treatment options are needed,” Wilson said. “And that need is met with implantable tibial neuromodulation.”
ITNM is an implantable form of PTNS designed to provide consistent symptom relief with minimal disruption to daily life. The device is placed near the ankle during a short outpatient procedure using only local anesthesia and is activated immediately. Symptom improvement usually occurs within 1-2 weeks. Patients typically resume normal activities quickly, with few post‑procedure restrictions.
In addition, the device lasts 15 years and requires recharging only one to two times per year!
“This treatment offers a long‑lasting option that combines effectiveness with convenience,” Wilson said. “It fills a critical gap between temporary therapies and more invasive procedures.”
Wilson, who has more than 25 years of experience treating overactive bladder and UUI, is the first physician in Alabama to offer this therapy. She says the technology represents an important step forward for patients seeking durable, patient‑friendly solutions.
“This is an exciting advancement for bladder care in our state,” Wilson said. “I’m proud to bring this option to UAB and to the many patients who stand to benefit from it.”