Overview
Millions of people suffer from bladder control issues every year. Worrying about your bladder control can keep you from doing the things you love. When lifestyle changes and medications don’t work, there are other options to help you regain control.
InterStim Therapy is an FDA-approved treatment for overactive bladder and urinary retention. It works by using Sacral Nerve Stimulation (SNS) therapy. This is a minimally invasive surgical option that involves the implantation of the small medical device to stimulate the sacral nerve. InterStim is a third-line therapy used to control overactive bladder symptoms developed by Medtronics.
Symptoms of Bladder Control Problems
Millions of people suffer from a bladder control problem known as overactive bladder. This condition involves the need to urinate frequently both day and night.
Signs and symptoms of bladder control problems include:
- Frequent urges to urinate (urgency-frequency)
- Inability to hold urine/leaking (urge incontinence)
- Inability to urinate (complete urinary retention)
- Incomplete bladder emptying (partial urinary retention)
Treatment of Bladder Control Problems
If you have been diagnosed with a bladder control problem, treatment typically begins with conservative, non-surgical options, including:
- Kegel exercises
- Medications
- Physical therapy
- Fluid/diet changes
If these conservative treatments have not worked for you, InterStim Therapy may be an option.
How InterStim Therapy Works
The sacral nerves, located near your tailbone, control the bladder. If these nerves don’t communicate correctly with the brain, the bladder does not function properly.
InterStim Therapy stimulates these nerves so they can communicate with the brain for increased bladder control. Neurostimulation is a reversible treatment that can be discontinued at any time by turning off or removing the device.
Neurostimulation may help you resume normal activities — and help you avoid frustrating experiences associated with an overactive bladder.
Who are candidates for InterStim therapy?
Sacral nerve stimulation is intended for patients who have failed or cannot tolerate more conservative treatments. Bladder control problems that may improve with SNS therapy include:
- Overactive bladder – Includes urge incontinence, urgency, and frequency.
- Urge incontinence – The involuntary loss of urine associated with a sudden, strong desire to void (urgency).
- Urgency-frequency – Frequent, uncontrollable urges to urinate (urgency) and voiding often in very small amounts (frequency).
- Urinary retention – The inability to empty the bladder.
- Fecal Incontinence – The inability to control your bowels.
Sacral nerve testing
Before starting InterStim therapy, a provider will conduct two tests to determine if this therapy will be effective for the patient:
Basic Test
This is an in-office procedure in which temporary leads are placed into the sacral nerve using local anesthesia. After the leads are placed, a test will be performed to ensure that the sacral nerve is being stimulated. This can be easily verified by the movement of the big toe. Regardless of overall test outcomes, these leads will be removed from the office after one week.
Advanced Test
This test is performed in the operating room on an outpatient basis. This is generally indicated for patients who have urinary retention, in which a longer sacral nerve stimulation is necessary. Rather than placing temporary leads, this procedure uses one long-term lead that is left in the sacral nerve for a minimum of two weeks. If the patient is recommended for permanent placement of the InterStim device, this lead will remain in place and be connected to the InterStim after the test period is complete. If the patient is not recommended for the InterStim, they will still require a second surgery to remove the long-term lead.
The Testing Period
The potential benefit of the therapy can be demonstrated by a trial assessment. The trial assessment takes 3-7 days and lets you try neurostimulation to see if it is right for you without making a long-term commitment. The test procedure uses an external stimulator and test system that can be placed in a 45-60 minute procedure.
The Results
During your trial period, you will keep track of your urinary symptoms in a bladder diary. If your symptoms are significantly reduced or eliminated during the testing period, you may benefit from long-term use of sacral nerve stimulation.
InterStim Therapy is appropriate for many patients who do not adequately respond to medication therapy, cannot take medications due to side effects, or do not want to take medications for the rest of their lives. Deciding if you are a candidate for InterStim Therapy is a two-part process. There is a test procedure to determine if you are a candidate, followed by implantation of a small device if the test improves your symptoms significantly.
Take the Next Step
If the conservative treatments mentioned above have not been successful for you, contact Urology Associates of Central Missouri by calling 573-499-4990 to explore your treatment options. Or request an appointment here.