Dr. Jason Kim

So that favors equine.

Each company has their pivotal trial basically tells the one-year success rates.

And for overactive bladder urgency incontinence, it's kind of a standardized greater than 50% improvement in urgency incontinence episodes.

And the improvement rates at one year range from 61% to probably around 80% at two years.

It's from 55% to about 80% also.

There's some differences in the patient populations.

We can't really compare directly.

We do see that they work, you know, but also we have to understand there's not a test for these devices, meaning like sacral neuromodulation where we do a percutaneous nerve evaluation or stage procedure.

There's no test to see if it works before we implant it.

So we also have to accept that if it works 75% of the time or a greater...

If there's 50% improvement greater than 75% of the time, 25% of the patients may be considered non-responders.

Since the implantable tibial nerve devices have been approved, I find myself, especially when patients are failing medications, I go in the office.

I used to talk about Botox, sacral nerve modulation, and PTNS.

And now I've added implantable tibial nerve stimulation, but I walk in the room staring at ankles to see if they're good.

We can't put this in patients with peripheral vascular disease, a significant edema, neuropathy, so I'm looking at ankles.

It is a good option.

When you're a resident, we did a study that showed patients, they actually, there's a significant preference for implantable tibial nerve stimulators.

We also showed that brings a new cohort of patients that didn't like any of the other procedural interventions.

But I think one of the places I've noticed we're getting a lot of converts is stable PTNS patients.

We get a lot of PTNS patients who jump to it because it's, as I mentioned, holistic.