Bladder Incontinence and the Percutaneous Nerve Evaluation

There's a lot of important matters that you need to think about prior to having a permanent bowel implant operation. Metropolitan Urological Specialists in St. Louis, Missouri wants to furnish you with an introduction to some of the symptoms that could lead to this kind of procedure and then let you know about a very important test that your physician may advise that you take before the procedure.

What are “bothersome” bladder symptoms?

•   Leakage of large or small amount of urine
•   Urinating often
•   Urinating urgently
•   Waking up at night to urinate
•   Inability to completely empty the bladder, or may be not able to urinate at all

What are “bothersome” bowel symptoms?

•   Fecal leakage
•   Fecal smearing
•   Diarrhea
•   Constipation

How common are bladder control problems?

•   Over thirty-three million people (1 in 6 adults) suffer from urinary control issues in the United States alone.
•   These issues may affect both males and females.
•   It may affect people of all ages; it isn't just a normal part of the aging process.
How common are bowel control issues?
•   Over 18 million individuals or 8.3% of adults suffer from symptoms of bowel control.
•   Likely more prevalent than reported due to the embarrassing nature of condition.

What are the causes of “bothersome” bladder and bowel symptoms?

•   There could be multiple causes; including, injury, side effects from particular medications, neurologic diseases, infection, bearing children, pelvic pain, and others.
•   Dr. Naughton, one of Metropolitan Urological Specialists’ top doctors makes it a priority to rule out medical causes of “bothersome” bladder and bowel symptoms.  Then, based on how these symptoms affect quality-of-life of the person, she will make suggestions on treatments.

Before placement of the permanent implant, your doctor may recommend a Percutaneous Nerve Evaluation. A Percutaneous Nerve Evaluation (PNE) is a simple office test which allows you a chance to test two temporary leads (or wires) into the pelvic nerves.  Under local anesthesia in an office setting, two temporary leads are positioned on each side of the pelvic nerves.  The leads are fixed to the back and connected to an external battery the size of a beeper.  The patient will have the opportunity to test both leads over the next 3-5 days to determine if there are any changes to the bladder and/or bowel symptoms.  We look at a fifty percent improvement in symptoms a positive test, which makes the patient a prospect for implantation of the permanent device.

What to know about the Percutaneous Nerve Evaluation (PNE) Procedure

1.   Please show up thirty minutes before your scheduled appointment time.
2.   You might drive yourself to the procedure; however, it is considerably better to have somebody drive you both to and from the procedure.
3.   This procedure is completed in the office under local anesthesia.
4.   Don't eat 2 hours prior to your procedure.  A light snack or meal is acceptable 2 hours before your procedure.
5.   Give up aspirin and ibupfren products (Motrin, Alleve, etc.) no less than five days before your procedure.
6.   Let our scheduler know whether you're taking blood thinners, such as Coumadin (warfarin), Xaralto, etc.
7.   No baths or showers during the test period.
8.   Abstain from heavy lifting or excessive bending during the trial.

What you should expect on the day of the PNE procedure:

1.   You will meet a medical assistant and agent(s) from Medtronic; the product company.
2.   You're going to be told to lie on your stomach.  The medical assistant will wash off your back and buttocks.
3.   Dr. Naughton will perform the procedure with the help of the Medtronic agent.
4.   The Medtronic agent and the medical assistant will secure the leads to your back, wipe off the cleaning solution on your back and buttocks before you get dressed.
5.   Following the process, you will talk with the Medtronic representative to review voiding and bowel diary instructions and set up contact plans with the representative to go over changes in your urinary and bowel function during the trial period.
6.   You will make an appointment to see Dr. Naughton in 3 to 5 days in the office before you leave to remove the leads and talk about the results of your trial.

If you have any questions before the procedure, call the procedure scheduler at the offices of Metropolitan Urological Specialists at 314-315-9933 during regular business hours. If you have questions about this procedure or anything else associated with bladder problems, schedule an appointment with one of our offices in the St. Louis area, including Washington, Florissant, and Creve Couer, Missouri.