Urge urinary incontinence (UUI) affects millions of people, nearly 16 million in the United States,^1,2 causing sudden, intense urges to urinate followed by involuntary leakage. Living with UUI can be challenging, but there are effective treatment options available. In this article we’ll explore what UUI is, its impact, and how Altaviva™ therapy offered by Dr. Angel Marie Johnson can help.

What is Urge Urinary Incontinence?

Urge urinary incontinence is a type of bladder control issue characterized by a sudden, strong need to urinate, often resulting in leakage before reaching a restroom. Common symptoms include:

• Frequent need to urinate
• Difficulty holding urine
• Leaking urine unexpectedly

Studies have shown that patients with UUI may experience diminished quality of life, which can affect social interactions, mental health, and sleep.^3,4

“There are a lot of misunderstandings about urge urinary incontinence,” said Dr. Johnson. “Many people believe it’s just something you must accept as you get older, or that there aren’t any real solutions. But that’s simply not true. While urge incontinence is common, it’s not an inevitable part of aging—and there are effective treatments available that can make a real difference.” 

To encourage patients to seek help, Dr. Johnson is raising awareness about how widespread—and manageable—urge urinary incontinence truly is. Dr. Johnson emphasizes that for many individuals, lifestyle adjustments and medications may not help. That is why she often discusses innovative options such as the Altaviva™ device from Medtronic, an implantable tibial neuromodulation therapy. 

Altaviva™ therapy works by placing a small device under the skin near the ankle in a single procedure that does not require sedation or radiology.⁵ This device sends electrical signals that stimulate the nerves that control the bladder.6,7 These signals help to restore the communication pathway between the brain and bladder, 6,7 which may reduce urgency with leaks.⁸ This treatment is called tibial neuromodulation, a proven therapy for reducing bladder control symptoms. ^{8, 9-13}

“The Altaviva device has been great additional therapy to now provide to my patients,” says Dr. Johnson, “This minimally invasive option has helped expand the available treatment options and allows me to work with my patients to determine the best treatment option for them.” 

To learn more about this therapy, schedule an appointment or visit Medtronic.com/Altaviva.  

In addition to risks related to surgery, complications can include pain at the implant site, lower leg pain, infection, and/or technical or device problems. Individual results may vary. Talk to your doctor to see if the Altaviva™ system is right for you.

1. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327-336.
2. US Census Bureau 2020. US adult and under-age-18 populations: 2020 census. https://www.census.gov/library/visualizations/interactive/adult-and-under-the-age-of-18-populations-2020-census.html. Accessed January 31, 2025.
3. Coyne KS, Payne C, Bhattacharyya SK, et al. The impact of urinary urgency and frequency on health-related quality of life in overactive bladder: results from a national community survey. Value Health. 2004;7(4):455-463.
4. Dmochowski RR, Newman DK. Impact of overactive bladder on women in the United States: results of a national survey. Curr Med Res Opin. 2007;23:65-76. 
5. M028930C001RevB - Altaviva™ Model P7850N Neurostimulator Implant Manual 
6. Li X, Li X, Liao L. Mechanism of action of tibial nerve stimulation in the treatment of lower urinary tract dysfunction. Neuromod. 2023;27:256-266. 
7. Bhide AA, Tailor V, Fernando R, Vik K, Digesu GA. Posterior tibial nerve stimulation for overactive bladder - techniques and efficacy. Int Urogynecol J. 2020;31:865–70. 
8. Medtronic Altaviva Clinical Summary 2025.  
9. Peters KM, Carrico DJ, et al. Randomized trial of percutaneous tibial nerve stimulation versus sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol. 2010;183:1438-1443. 
10. Peters KM, MacDiarmid SA, Wooldridge LS, et al. Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol. 2009;182(3):1055-1061. 
11. Kobashi K, Nitti V, Margolis E, et al. A prospective study to evaluate efficacy using the NURO percutaneous tibial neuromodulation system in drug-naïve patients with overactive bladder syndrome. J Urol. 2019;131:77-82. 
12. Rogers A, Bragg S, Ferrante K, et al. Pivotal study of leadless tibial nerve stimulation with eCoin for urgency urinary incontinence: an open-label, single arm trial. J Urol. 2021;206:399-408. 
13. Heesakkers JPFA, Toozs-Hobson P, Sutherland SE, et al. A prospective study to assess the effectiveness and safety of the BlueWind system in the treatment of patients diagnosed with urgency urinary incontinence. Neurourol Urodyn. 2024;43:1491-1503. 

Medtronic Altaviva™ tibial neuromodulation system treats urge urinary incontinence (leakage). It should be used after you have tried other treatments such as medications and behavioral therapy, and they have not worked or you could not tolerate them. 

This therapy is not for everyone. The Altaviva™ system is contraindicated (not allowed) for patients who are poor surgical candidates including patients with open wounds, sores, or damaged skin near the treatment area; current or recent history of poor blood circulation in the legs or open sores on the legs from circulation problems; physical changes or previous surgeries where the Altaviva™ device is placed. You must be able to operate or receive assistance in operating the system to be a candidate. 

This therapy is not intended for patients who: are not good candidates for surgery or have conditions that make it hard to heal from wounds (such as uncontrolled diabetes, swelling in the lower leg, or nerve problems in the leg); have metal implanted within 5 cm of where the Altaviva™ device would be placed; have a current or unresolved blockage in the urinary tract caused by things like an enlarged prostate, cancer, or urethral narrowing; are allergic to any materials in the Altaviva™ device. The Altaviva™ system may affect or be affected by other implanted medical devices, including pacemakers and defibrillators. Talk to your doctor if you have a pacemaker or other implanted devices. You cannot have diathermy (deep heat treatment using shortwave or microwave electromagnetic energy) if you have an Altaviva™ device. Do not place the charger or ankle band on broken or unhealed skin. Safety and effectiveness have not been established for pregnancy; patients under the age of 18; patients with progressive, systemic neurologic disease; patients with history of urinary retention, or bilateral stimulation. 

In addition to risks related to surgery, complications can include pain at the implant site or lower leg pain, infection, wound complications, nerve injury, movement of the implant, undesirable change in bowel or bladder function, uncomfortable or unintended stimulation sensations, unexpected shocking sensation, loss of therapeutic effect, discomfort when recharging, or technical or device problems.

This therapy is not for everyone. This treatment is prescribed by your doctor. Please talk to your doctor to decide whether this therapy is right for you. Your doctor should discuss all potential benefits and risks with you. Although many patients may benefit from the use of this treatment, results may vary. 

For complete safety information about this treatment, please visit the Medtronic website at www.medtronic.com.

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