Overactive Bladder

Overview

Overactive bladder (OAB) is a common condition that affects millions of Americans. Overactive bladder isn’t a disease. It’s the name of a group of urinary symptoms. It is a problem with bladder-storage function that causes sudden urge to urinate. The most common symptom of OAB is a sudden urge to urinate that you can’t control. Some people will leak urine when they feel the urge. Leaking urine is called “incontinence.” Having to go to the bathroom many times during the day and night is another symptom of OAB.

 

Risk Factors

  • Age
  • Post-menopausal in women
  • Underlying chronic infections of the urinary tract
  • Obstructive diseases

Signs & Symptoms

Urgency

The major symptom of OAB is a sudden, strong urge to urinate that you can’t ignore.

 

Leak Urine

The feeling that you need to get to the bathroom right away. You may leak urine after you feel the urgency. This maybe a few drops or a large amount of urine.

 

Frequency

Urinating greater than 8 times a day and waking up several times from sleep at night

 

If you think you may have OAB, we can help. Sometimes OAB symptoms can be the result of a urinary tract infection, an illness, damage to nerves, or a side effect of a medication. So it’s important to go to a health care provider to find out if you have any of these problems. If you do have OAB, there are treatments to help. Together, we can choose what is best for you.

Diagnosis & Treatment

There are a number of treatments to help manage OAB. We may prescribe treatment to help you manage your symptoms.

 

Treatment choices for OAB include

  • Lifestyle changes
  • Medical and surgical treatments
  • Managing leakage with products and devices

 

No single treatment is right for everyone. Your urologists may use 1 treatment alone, or several at the same time. You and your urologist should talk about what you want from treatment and about each treatment choice.

 

What Is InterStim Therapy?
Medtronic InterStim Therapy helps control bladder problems by sending mild electrical pulses to target the communication problem that exists between the sacral nerves (located near the tailbone) and the brain.

 

In some people, the brain and sacral nerves, which control the bladder, do not communicate correctly, so the nerves cannot tell the bladder how to function properly. Doctors have referred to InterStim Therapy as a pacemaker for the bladder.

 

Indications and Recommended Use
InterStim Therapy was approved by the Food and Drug Administration (FDA) in 1997 for urge incontinence and in 1999 for urinary retention and significant symptoms of urgency-frequency. InterStim Therapy is recommended for patients with bladder control problems who have not had success with common treatments such as Kegel exercises, fluid and diet changes, physical therapy and/or medication.
InterStim Therapy is not intended for patients with a urinary blockage.

 

Benefits and Risks
InterStim Therapy provides another treatment option for bladder control problems, such as leaking, urgency and frequency. Medtronic’s medical technologies help make it possible for millions of people to resume everyday activities, return to work and live better, longer.
Many people treated with InterStim Therapy have reported improved quality of life and freedom to live without worry of leaks.

 

Treatment with InterStim

Therapy begins with a three to seven-day trial assessment so a patient can test the therapy without making a long-term commitment. If good results are achieved from the trial, the patient may receive long-term InterStim Therapy (an implantable neurostimulator). Even after implantation, the treatment is reversible and can be discontinued by turning off or removing the device at any time.

 

Implanting an InterStim Therapy system has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection.
In addition to risks related to surgery, complications can include pain at the implant sites, new pain, infection, lead (thin wire) movement/migration, device problems, interactions with certain other devices or diagnostic equipment, undesirable changes in urinary or bowel function, uncomfortable stimulation (sometimes described as a jolting or shocking feeling), and others. For additional information, see Important Safety Information. Patients should always discuss the potential risks and benefits with a physician. This therapy is not for everyone. A prescription is required.

 

Patients should consider InterStim Therapy when other treatments have not been successful and their bladder control problems have affected their lifestyle to the point where they have curtailed activities such as traveling or going to the gym.
InterStim Therapy does not treat every type of bladder control problem. It is not intended for patients with conditions such as benign prostatic hyperplasia (BPH), cancer, urethral stricture, or stress incontinence, all of which may produce urinary symptoms.

How InterStim Works
Treatment with InterStim Therapy involves trial assessment, surgical implant and long-term follow up.

 

Trial Assessment

During a 3-7 day trial assessment, which can occur in a simple outpatient procedure in a urologist’s, gynecologist’s or urogynecologist’s office, the doctor numbs a small area and inserts a thin, flexible wire near the sacral nerves. The wire is taped to the skin and connected to a small external stimulator that is worn on the waistband. The stimulator sends mild electrical pulses to the sacral nerves. In a successful trial, patients should experience significant improvement in their symptoms.

 

Surgical Implant

Following a successful trial, the temporary flexible wire is removed and replaced with a permanent flexible wire, or lead. Once in place, the other end of the lead is passed under the skin and connected to a small stimulator. The stimulator itself — about the size of a pocket watch — is implanted under the skin in the upper buttock. This minimally invasive procedure is often performed as an outpatient procedure while the patient is under local anesthesia.

 

Long-Term Follow Up

Following implant, the neurostimulator is activated. The neurostimulator sends mild electrical pulses via the lead to the sacral nerve. Physicians can adjust the stimulation to optimize the therapy for each patient, and follow-up examinations usually occur every six to 12 months to monitor the therapy’s effectiveness. A patient programmer (like a remote control) also allows patients to adjust the intensity of the stimulation and gives patients some control in managing their therapy.