A TEAM APPROACH TO CARE
Interstim for Urinary Incontinence
The InterStim Therapy system is essentially a small electrical device that stimulates the sacral nerves in the lower back that control bladder function. The device is implanted just above the tailbone where it can send very mild electrical pulses to the sacral nerves, using an external stimulation device and allowing the patient gain control over their need to urinate. The InterStim can provide the following benefits:
- Reducing or eliminating the need for catheters
- Limiting urgency-frequency episodes
- Alleviating sensations of suddenly needing to urinate
- Improving nerve communication between the bladder and brain
What Bladder Control Problems are Treatable ?
InterStim therapy has been shown to help patients alleviate symptoms associated with the following bladder control issues:
- Urge Incontinence: Causes a sudden urge to urinate. Urge incontinence is also referred to as an overactive bladder and may occur due to a bladder infection, bladder cancer, nervous system diseases, and other health conditions.
- Urinary Retention: Makes it difficult for an individual to empty the bladder. A person who is dealing with urinary retention may be unable to start urinating. Or, a person who is suffering from urinary retention may begin urinating but is unable to fully empty his or her bladder.
- Frequent Urination/Frequent Urge to Urinate: Occurs when a person passes only small amounts of urine, urinates frequently, and/or cannot fully empty his or her bladder.
Am I a good candidate?
Sacral nerve stimulation may be an effective treatment option if you suffer from an overactive bladder or other forms of female urinary incontinence, urinary retention issues, or urgency-frequency. The InterStim system is not recommended for patients diagnosed with stress female urinary incontinence or urinary obstructions. However, it is crucial to discuss your options with an experienced urologist who can thoroughly examine your specific situation and determine a personalized treatment plan.
What to Expect
A urologist strives to ensure a patient knows exactly what to expect leading up to an InterStim test stimulation. He or she teaches a patient about all aspects of a test stimulation, as well as responds to any concerns or questions.
Typically, a urologist conducts a physical examination and requests a bladder diary and medical history prior to performing an InterStim test stimulation. A urologist also performs a urodynamic study to analyze the bladder function and cystoscopy, which enables him or her to see a patient’s bladder via a hollow scope with a lens.
If a patient is a good candidate for InterStim therapy, a urologist may recommend a test stimulation. On the other hand, if a patient does not qualify for InterStim therapy, a urologist will offer alternative urinary incontinence treatment recommendations.
How is Interstim implanted?
The InterStim device can be safely implanted during a minimally invasive surgical procedure. First, a temporary electrode or lead is implanted in the lower back or abdomen with an external wire that exits the body and attaches to a test stimulator. The temporary system is used to test how well your body responds to the neurostimulation. You will have up to a week to test the system before moving forward with the long-term lead and neurostimulator.
During the stimulation test period, a patient can control the amount of stimulation that he or she feels. The temporary system includes a control knob that ensures a patient can adjust the amount of stimulation at any time. It is important for a patient to always feel stimulation throughout the duration of the test period and increase or decrease the amplitude as needed. If a patient feels uncomfortable during the test period, he or she can adjust the stimulation.
A patient will need to avoid strenuous activities and sexual intercourse during the stimulation test period. He or she should do everything possible to keep all wires in place. Also, it is crucial for a patient to keep the operative sites dry at all times.
If the test is a success, the external wire will be removed and the neurostimulator will be placed under the skin and attached to the electrode, which will be operated by a handheld device that can control the level of stimulation. Most patients describe using the InterStim system as feeling like a tingling or vibrating sensation. When the device is turned on, it sends electrical signals to the nerves that control bladder function, allowing the patient to trigger urination when ready.
For those who decide to move forward with a permanent InterStim stimulator, a urologist usually schedules the follow-up procedure within about one week of the test period. After a permanent stimulator procedure is completed, a urologist requests a follow-up appointment within two weeks as well. A urologist also asks a patient to maintain a diary to track his or her long-term progress.
It can be frustrating and limiting to live with urinary incontinence, however, there are many incontinence treatment options available that can be customized to suit each patient’s needs. You can gain control and independence once again with the help of the skilled physicians at Comprehensive Urology in Los Angeles. To learn more about the InterStim neurostimulator system and whether it is the best urinary incontinence treatment option for your condition, please schedule a consultation today!
What are the risks?
The risks associated with InterStim therapy are minimal, and they include:
- Ongoing bladder problems
- Lead migration
A urologist outlines the risks associated with InterStim therapy prior to treatment. By doing so, he or she helps a patient weigh the benefits and risks of InterStim therapy.