​Donald K. Liebell, DC, BCAO

477 Viking Drive Suite 170

Virginia Beach VA 23452 
8:30AM - 6:30PM M,W,F 

(By Appointment Tu, Sat) 


The Liebell Clinic: Chronic Pain & Wellness Solutions

Natural & holistic, whole-person, wellness-based Healthcare - Drug-Free & Non-Surgical Pain Relief


Research Study References

Randomized trial of transcutaneous tibial nerve 

stimulation to treat urge urinary

 incontinence  in older  women

Schreiner, Lucas; dos Santos, Thaís Guimarães; Knorst, Mara Regina.

International Urogynecology Journal, 09/2010, Volume 21, Issue 9

Sustained effectiveness of percutaneous tibial nerve stimulation for overactive bladder syndrome: 2-year follow-up 

of positive responders

Yoong, WA, Shah, P; Dadswell, R; Green, L. 

International Urogynecology Journal

24.5  (May 2013)

Percutaneous Tibial Nerve Stimulation

and Overactive Bladder

Sajadi, Kamran P; Goldman, Howard B,

Current Urology Reports,

09/2010, Volume 11, Issue 5

Posterior tibial nerve stimulation as neuromodulative treatment of lower

urinary tract dysfunction.

66(3):914-918. Van Balken MR, Vandoninck V, Gisolf KW, Vergunst H, Kiemeney LA, Debruyne FM, Bemelmans BL: 

The Journal of Urology


Sustained Therapeutic Effects of Percutaneous Tibial Nerve Stimulation:

24-month Results of the STEP Study

Kenneth M. Peters, Donna J. Carrico, Scott A. MacDiarmid, Leslie S. Wooldridge, Ansar U. Khan, Craig E. McCoy, Nicholas Franco, and Jason B. Bennett

Neurourology and Urodynamics
32:24–29 (2013) 

Cost of Neuromodulation Therapies for Overactive Bladder: Percutaneous Tibial Nerve Stimulation Versus Sacral Nerve Stimulation.

M. Martinson, S. MacDiarmid, E. Black. Journal of Urology

(Volume 189, Issue 1, January 2013,

Pages 210-216)

Cost-effectiveness of percutaneous tibial nerve stimulation versus extended release tolterodine for overactive bladder

 H. W. Chen, R. S. Bercik, E. F. Werner

And S. F. Thung

 Journal of Urology

 2012; 187: 178-184.

Financial Impact of Percutaneous Tibial Nerve Stimulation (PTNS) Treatment [10G]

Harmouche Jihad; Kurdoglu, Zehra MD; Kilic, Gokhan MD.

Obstetrics & Gynecology

May 2017

The efficacy of acupuncture in reversing unstable bladder in pig-tailed monkeys


Stoller ML, Copeland S, Millard AR et al[Abstract 2]

Journal of Urology 

(Suppl. 137), 104A (1987).

Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial.

Liu Z, Liu Y, Xu H, et al. 

Journal of the American Medical Association (JAMA) 2017; 357: 2493- 501.  

The Efficacy and Safety of Electroacupuncture for Women with Pure Stress Urinary Incontinence:

Study Protocol for a Multicenter Randomized Controlled Trial

Liu, Zhishun, et al.

Trials, vol. 14, no. 1, 2013, pp. 315-315.

Electroacupuncture Improves Bladder and Bowel Function in Patients with Traumatic Spinal Cord Injury: Results from a Prospective Observational Study

Liu, Zhishun, et al.

Evidence-Based Complementary and Alternative Medicine, vol. 2013, 2013, p1-9

Electroacupuncture is Beneficial in Women with Stress Incontinence

Rosenberg, Karen. 

American Journal of Nursing

vol. 117, no. 10, 2017, pp. 61-62.

Effects of electroacupuncture on overactive bladder refractory to anticholinergics: A single-blind randomised controlled trial.

Zhang, J., Cheng, W., & Cai, M

Acupuncture in Medicine

(2015), 33(5), 368.

Multiple Sclerosis Patients with Bladder Dysfunction have Decreased Symptoms After Electro-Acupuncture

Soe, S. H. T., et al. 

Multiple Sclerosis

vol. 15, no. 11, 2009, pp. 1376-1377.

Acupuncture for Overactive Bladder

in Female Adult:

A Randomized Controlled Trial

Yuan, Zhengyong, et al. 

World Journal of Urology

vol. 33, no. 9, 2015, pp. 1303-1308.

Cost of Neuromodulation Therapies

for Overactive Bladder: Percutaneous

Tibial Nerve Stimulation Versus

Sacral Nerve Stimulation

M. Martinson, S. MacDiarmid, E. Black. 

Journal of Urology

Volume 189, Issue 1, Jan 2013, P210-216

Cost-effectiveness of percutaneous tibial nerve stimulation versus extended release tolterodine for overactive bladder

H. W. Chen, R. S. Bercik, E.

F. Werner and S. F. Thung;

Journal of Urology

2012; 187: 178-184.

Conservative chiropractic management

of urinary incontinence using applied kinesiology: a retrospective

case-series report

Scott, C., Rosner A., ​

Journal of Chiropractic Medicine 
(2012) 11,49-57 

​​​      I'm here to help, and I'll be glad to personally answer your questions.  Please type your first name in the box on the contact form.  Please check the box to receive email updates to give me permission to correspond with you by email, and type your question in the message box.  

   I respond to questions in the order I receive them, 

usually within 1-3 business days.  My responses are for

general information only, and must not be considered as

advice for specific medical treatment or diagnosis

.   For appointments, please call my office at: (757) 631-9799.  

     Your email address or other information is confidential; I will never share it with anyone, nor will it be used for any form of solicitation.   I look forward to your questions! 

Published medical research proves it works great…

but has your doctor told you about it?

The Easy, Safe, Affordable, Drug-Free,
and Non-Surgical Treatment for
Stress Urinary Incontinence

   By Dr. Donald Liebell

If you suffer urinary drips and leaks when you cough, sneeze, or laugh… or you have an overactive bladder… you’ll want to read every word of this article.

Although few doctors seem to mention it… there’s an amazing treatment proven to improve bladder control function. This means less dripping, leaking, and other urinary problems. You might not be destined for adult diapers, risky medications, or implanted surgical devices after all!

In just 12 weeks, there’s realistic hope for lasting improvement. Urologists call the safe and easy treatment Percutaneous Posterior Tibial Nerve Stimulation (PTNS). 

There are no drugs involved, which means there are no side effects or drug interactions to worry about. There is no need for any surgically-implanted device or anesthesia.

12 easy weekly treatments get the job done.

All you need to do is sit and relax in a recliner chair. You can nap, read, text, listen to music, watch video, etc. during the painless 30-minute treatment. The PTNS treatment is a mild pinpoint electrical stimulation to the foot and ankle. It transmits up a nerve in the leg (tibial nerve) to stimulate the nerves at the bottom of the spine which control bladder function.

More than 30 medical studies have been published regarding PTNS. Research has revealed that its benefits are corrective and lasting.

Despite substantial medical proof, it is quite likely you never heard of it.

Has your doctor ever mentioned it?

If this treatment really could be the answer to incontinence and other bladder problems for millions of people (published medical research says it is!)… why in the world hasn’t PTNS been front-page news?

It absolutely should be!

I will explain why it is not publicized properly. But more importantly, you’ll find out how easily you will be able to get this safe, easy, and affordable treatment right away.

Here’s the story:

According to a research paper published in the Journal of Obstetrics and Gynecology (February 2010), Chinese acupuncture is what inspired doctors to investigate this technique, way back in 1983. The authors confirmed a “60–80% positive response rate after 10–12 weekly treatments with PTNS.”

Sound great, right? Indeed it is!

This easy treatment actually gets your bladder to naturally control itself better. Within just 12 weeks, you could see significant improvement with leaks and drips, urgency to urinate, general bladder control, and according to the medical studies, even improve sexual function.

PTNS is performed by a technician, typically at a urologist’s office. He or she puts an acupuncture needle into a widely-known ancient Chinese acupuncture point on the ankle. It’s called Spleen 6 (SP6). You barely feel this at all. Then, an electrical stimulator is attached by wire to the needle, and a small sticky electrode pad goes on the arch of the foot near your heel.

You might be wondering what they meant by saying PTNS was “inspired” by acupuncture? What in the world do they mean? It sounds fishy to me… and it is… here’s why:

PTNS is not really a new modern medical discovery. It is not “inspired” by acupuncture…

It is acupuncture!
Specifically, it is electro-acupuncture, which was developed and introduced in China around 1934. The benefits of acupuncture needling are enhanced by a safe and mild electrical current.

It is shameful that most of the research papers and urologists’ articles do not even mention the word, acupuncture. If you read the PTNS studies published in mainstream medical journals, they do not dispute the fact that an acupuncture needle is used, or that it is placed at Chinese acupuncture point SP6. 

Although they cannot deny the materials and methods of treatment; they disguise the fact that PTNS is acupuncture by using decisively non-acupuncture medical jargon. I think this is quite unprofessional, unethical, and deceptive.  

Have conventional Western doctors and researchers staked a claim for “discovering” acupuncture by giving it a new name, Percutaneous Posterior Tibial Nerve Stimulation?

Think about it: the medical term, percutaneous literally means through puncture of the skin.

Hmm… sounds like acupuncture to me!

These research papers stipulate that weekly PTNS treatments should be administered for 30 minutes with electrical stimulation through a needle electrode (acupuncture needle) and sticky pad electrode on the foot at settings of 20 hertz frequency, 0.5-10 milliamperes pulse intensity, and a 200 milliseconds pulse width.

What is “specialized” about this?

Nothing… such treatment can be provided with great competence, by acupuncturists worldwide using common long-existing electrical stimulation devices (I have several). No claims of specialized “new” medical devices or patented “systems” are necessary.  

More Monkey Business?

In 1987, medical researchers conducted a study on bladder problems with monkeys using the so-called PTNS technique. Monkeys… seriously? Was it really necessary to study time-tested and safe acupuncture methods on monkeys?

Was this meant to give the illusion of new scientific medical research? It sounds like backwards science to me because humans have been helped by traditional Chinese acupuncture needling for thousands of years!

Acupuncturists (and those whom they have helped) have not needed validation from the gatekeepers of conventional Western medicine that it works beautifully. Electro-acupuncture’s excellence in support of stress urinary incontinence and other bladder problems has been long proven. No attempt to try to make acupuncture sound like a mainstream medical treatment has been necessary. Plus, professional academic scientific journals have published studies on acupuncture’s success with urinary incontinence (without calling it PTNS).

It seems crystal clear that the efforts of Traditional Chinese medicine’s acupuncturists have been hijacked, repackaged, renamed, and remarketed as “PTNS.” Mainstream medicine no more discovered a new treatment for stress urinary incontinence than Christopher Columbus discovered America. Our continent was already inhabited by people for ages before Columbus showed up... and Western medicine did not discover acupuncture for urinary stress incontinence either… but they finally noticed it! 

“Why can’t mainstream Western medicine researchers just admit it, and give credit where credit is due?”
 Western medicine does not have a monopoly on scientific evidence. However, reading the PTNS studies makes me think they still claim sole ownership. Must they cling with a death grip to their unethical biases against natural and holistic healthcare?

There are urologists who market fantastic SP6 electro-acupuncture as PTNS. They describe it as a “state-of-the-art advanced treatment” using a specialized patented electrical stimulation device. The acupuncture needle is referred to as a “thin needle electrode” which is connected to a lead set. They will also call it neuromodulation.

Prior to 2000, there was no commercially-marketed FDA-approved device designated for PTNS as a conventional medical treatment. Acupuncturists and their patients know that no such device was necessary. However, once a device was produced and patented specifically as a urological medical device (for percutaneous posterior tibial nerve stimulation)… a “new” medical innovation was born (no, it wasn’t!).

No matter how you slice it, this is all a smoke and mirrors… just fancy and pretentious medical jargon for electro-acupuncture. Calling it neuromodulation does not change the fact that it is acupuncture!

“Whatever it’s called, if this treatment works so great… why is it NOT a very commonly prescribed treatment?”

Numerous medical studies have proven it can be equally or more effective than commonly prescribed incontinence drugs such as tolterodine or Botox. Despite research, PTNS is not frequently suggested by medical doctors.


Some studies report it’s cheaper to prescribe the drugs than to fix the problem with the electro-acupuncture. Yikes!

It seems that prescribing the drugs is much easier too. It’s not as if pharmaceutical sales people are breaking down doctor’s doors, desperate to tell them all about the amazing drug-free alternative proven by medical studies.

Perhaps this is the main reason why few doctors are likely aware of electro-acupuncture as a treatment option for urinary incontinence.

Then there’s the cost of the medically-designated PTNS equipment and technicians. In order to provide PTNS treatment, urologist’s offices must be staffed with employees who are licensed and trained to put in the acupuncture needle (although they don’t call it by its real name).

They must also purchase the costly “specialized” PTNS electrical stimulation system (apparently to justify billing treatment as PTNS). I will not dignify mentioning the name of this absurd, overpriced, and unnecessary medical device. 

The public doesn’t know about a wonderful treatment for stress urinary incontinence (and other bladder problems) because of… money!

What a surprise!

Urologists charge 2-5 time more for the same service performed by an acupuncturist!

This is not about effective and safe healthcare… this is about business!   

Despite mainstream medical journals calling it PTNS, and reporting it works great… the treatment is marketed as being more of a last resort. It might be suggested to a patient if prescription drugs don’t work, the patient doesn’t want to take more drugs, or the side effects are bad enough.

Speaking of side effects, tolterodine’s list of possible side effects include: allergic reactions, chest pain, heart problems, confusion, hallucinations, dry mouth or eyes, vision problems, dizziness, drowsiness, constipation or diarrhea, upset stomach, joint pain, headaches, and… yes…

Urinary problems! Hooray!

Wouldn’t it be cheaper, safer, easier, smarter, and ethically responsible if medical doctors simply referred their patients with urinary problems to acupuncturists?

Wouldn’t a practitioner trained, licensed, and experienced in acupuncture be more qualified? Acupuncturists already possess the skills and equipment to provide a vital healthcare service to the millions of women who suffer bladder problems. Seeking a professional who can do so much MORE with acupuncture than a PTNS technician (who is trained merely to insert and remove the “needle electrode”), gives you greater opportunity for health support.

In my practice, I can teach you corrective and preventive measures for you to help yourself with your bladder problems too. Women benefit tremendously when I teach them how to strengthen their pelvic floor muscles properly (hint: it’s NOT Kegel exercises!). Perhaps you will need some dietary changes, fitness and weight loss advice, and other wellness-based health support.   

I am a doctor who is licensed in acupuncture and chiropractic by the Virginia Board of Medicine. I am not a urologist, nor do I claim to treat stress urinary incontinence with their strangely-designated PTNS device. However, I am quite proud to provide safe and easy electro-acupuncture treatment… at a fraction of the cost of the so-called Percutaneous Posterior Tibial Nerve Stimulation (PTNS)!

There are many magnificent treatment methods that have been used all around the world, for ages. Yet it seems that mainstream medicine holds some of them hostage, and the public is rarely informed of their existence. This certainly appears to be the case for treatment for urinary stress incontinence. This problem is suffered by countless millions of women. The great news is that a medically proven treatment method is available right now at the Liebell Clinic.

The first step in addressing a bladder problem is seeing your medical doctor. Acupuncture is never a replacement for that. You must be appropriately medically evaluated first. Serious problems must be first ruled out. Electro-acupuncture is not performed on those who have pacemakers or defibrillators. It should not be performed on people with clotting disorders, some neurological conditions, and pregnant women.

If you would like an excellent chance at reducing or eliminating your urinary stress incontinence problem, I can provide the proven effective electro-acupuncture (1x/week, 30 minutes, 12 weeks), and so much more! Just give the Liebell Clinic a call at (757) 631-9799 on Mondays, Wednesdays, and Fridays.  

​Dr. Donald Liebell