Bladder Control Problems
You may be one of millions of people who suffer from frustrating and embarrassing bladder control problems. These conditions, which prevent you from controlling when and how much you urinate, can make simple, everyday activities a challenge and social lives very difficult. You may have to cut back on your hobbies or stop working. You may feel trapped by a fear of leaking accidents, the need to be close to a bathroom at all times, and an overall, preoccupation with your bladder.
You can be any age to have bladder control problems. You may try treatments such as diet changes, exercises, medications, and biofeedback. These treatments, however, do not always ease symptoms. In such cases, you must manage your bladder control problems with external collection devices such as catheters or absorbent under garments. Or, you may consider surgery.
Now, for those in whom more conservative treatments do not work well, there is a therapy that may, help. Medtronic InterStim® Therapy for Urinary Control may provide relief from symptoms and allow you to return to a more normal life.
Different Types of Bladder Control Problems
RETENTION
If you have retention you may:
- need a catheter to pass urine
- spend a long time at the toilet, but produce only a weak, dribbling stream of urine
- leak urine (sometimes called overflow incontinence)
- not have a sensation of when your bladder is full
With retention, you may store increasingly larger volumes of urine.
SYMPTOMS OF OVERACTIVE BLADDER
including:
Urge Incontinence
If you have urge incontinence, you may:
- lose urine as soon as you feel a strong need to go to the bathroom
- leak urine when you drink even a small amount of liquid, or when you hear or touch running water
- have frequent leaking episodes
Urgency Frequency
If you have urgency-frequency, you may:
- have frequent, uncontrollable urges to urinate
- go to the bathroom more often than normal (more than seven times a day)
- feel that your bladder is never completely empty
What Is InterStim Therapy?
InterStim Therapy is indicated for people with urinary retention and the symptoms of overactive bladder including urinary urge incontinence and significant symptoms of urgency-frequency in selected individuals:* The therapy uses a small implanted medical device to send mild electrical pulses to a nerve located just above the tailbone. This nerve, called the sacral nerve, controls the bladder and surrounding muscles that manage urinary function. The electrical stimulation may eliminate or reduce certain bladder control symptoms in some people.
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* InterStim Therapy does not treat symptoms of stress incontinence. InterStimTherapy has not been studied in pregnant patients, pediatric patients, patients with diabetes, or patients with multiple sclerosis. It is not intended for patients with mechanical obstructions such as benign prostatic hypertrophy, cancer or urethral strictures.
How Will I Know If InterStim Therapy Will Work for Me?
A physician's examination and evaluation can determine whether you are a candidate for InterStim Therapy. If your bladder control problems are not effectively managed by more conservative treatments and you have otherwise normally functioning urinary systems, you are a potential candidate. (See Patient Selection.)
A test (the temporary test stimulation) is used before implantation of the therapy to see what the effect of stimulation is on your symptoms. (See Test Stimulation) A test lead is surgically placed through a small incision near the appropriate sacral nerve, and mild stimulation with an external device is provided for several days. During the test stimulation, you will record your symptoms in a special diary. If symptoms improve or disappear during the test period, long-term use of InterStim Therapy may be appropriate for you.
What Does the Therapy Involve?
A lead (a thin wire with small electrodes at its tip) is surgically placed near the appropriate sacral nerve that controls urinary function. The lead is passed under the skin to a small neurostimulator (approximately the size of a stopwatch) that is placed in a "pocket" just beneath the skin.(See Minimally Invasive Tined Lead Implant)
The neurostimulator, which contains a special battery and electronics to control the stimulation to the sacral nerve, is usually placed by the physician in the upper buttock.
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The stimulator typically runs for 7-9 years and then can be replaced during an outpatient procedure.
Adjustments to the stimulation can be made in a physician's office with a hand-held programmer. InterStim Therapy is reversible - it can be programmed off at any time.
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What Are the Risks of InterStim Therapy?
52% of clinical study patients implanted experienced therapy related adverse events. 54% of these required hospitalization or surgery to resolve. No adverse events resulted in permanent injury. 9% were unresolved at database closure. The most common adverse events included pain at implant site, lead migration, and infection.
The surgical revision rate was 33% with the neurostimulator placed in the abdomen. In a later study the surgical revision rate was 15%, with the neurostimulator placed in the upper buttock.
How Do I Qualify for InterStim Therapy?
If you meet the following requirements, determined by a doctor's testing and evaluation, you may be eligible for InterStim Therapy:
- Poor results from more conservative therapies such as diet modification, medication, and biofeedback
- Positive results from the diagnostic test (the temporary test stimulation)
Only your physician can determine if InterStim Therapy is right for you.