Interstim Therapy for Bladder and Bowel Incontinence

Interstim Therapy was FDA approved in 1997 for the treatment of urinary urge, retention, and urgency/frequency.  It was authorized in 2011 for bowel accidents (fecal incontinence).

What exactly are annoying bladder symptoms?

• Leakage of small or large amounts of urine
• Urinating frequently
• Urinating urgently
• Getting up during the night to urinate
• Incapacity to fully empty the bladder, or may be not able to urinate at all (retention)

What exactly are annoying bowel symptoms?

• Fecal leakage
• Fecal smearing
• Diarrhea
• Constipation

How prevalent are urinary control issues?

• More than 33 million individuals (1 in 6 adults) suffer from urinary control problems within the United States alone.
• These issues can impact men and women.
• It may affect people of all ages; it is not just a regular part of the aging process.

Just how commonplace are bowel control issues?

Over 18 million people or 8.3% of adults are afflicted by symptoms of bowel control. Really, this affliction is most likely more prevalent than reported due to the embarrassing nature of the condition.

Exactly what are the factors that cause irritating bladder and bowel symptoms?

There might be multiple causes; like injury, side effects from specific medications, neurologic diseases, infection, bearing offspring, pelvic pain, and others.

How could I know whether Interstim Therapy is correct for me?

You will want to see a doctor with a special interest, training, and knowledge about Interstim Therapy.  Dr. Naughton, one of Metropolitan Urological Specialists’ physicians and voted Best Doctor in St. Louis for 10 consecutive years since 2007, concentrates on the management of bothersome bladder and bowel symptoms and has one of the best experiences with Interstim Therapy in Missouri.

Interstim Therapy has two phases:

1. Test trial period to find out if the therapy is suited to you—Percutaneous Nerve Evaluation (PNE)
2. Permanent Interstim Implant

Before placement of the permanent implant, your physician may suggest a Percutaneous Nerve Evaluation (PNE). PNE is an easy office test which allows you a chance to test two temporary leads (or wires) within the pelvic nerves.  Using local anesthesia in an office setting, two temporary leads are put on either side of the pelvic nerves.  The leads are taped to the rear and linked to an external battery the size of a beeper.  The patient will get the chance to test both leads over the next 3-5 days to find out if there are any changes to the bladder or bowel symptoms.  We consider a 50 percent improvement in symptoms a positive test, which makes the individual a candidate for placement of the permanent device.

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

• Please arrive 30 minutes before your scheduled meeting time.
• You might drive yourself to the procedure; but, it is substantially better to have somebody drive you to and from the procedure.
• This procedure is completed within the office under local anesthesia within 10-15 minutes.
• A small snack or meal is okay 2 hours before the procedure.
• Give up aspirin and ibupfren products (Motrin, Alleve, an such like) for at least 5 days before your procedure.
• Let our scheduler know whether you are taking blood thinners, including Coumadin (warfarin), Xaralto, and so forth.
• No baths or showers are permitted while in the testing period.  You may take sponge baths and clean your hair in the sink.
• Steer clear of heavy lifting or too much bending throughout the trial.

If you are not able to tolerate the PNE, there is an option to perform the trial phase in the operating room with anesthesia.  This is called a “Stage 1” procedure. You and the doctor will determine if a Stage 1 procedure is appropriate for you.

What you should expect on the day of the PNE procedure

• You will meet a medical assistant and representative(s) from Medtronic; the product company.
• You will be directed to lay on your stomach.  The medical assistant will wash off your back and buttocks.
• Your physician will perform the procedure with the assistance of the Medtronic agent.
• The Medtronic agent and the medical assistant will fasten the leads to your back and wipe off the cleaning solution on your back and buttocks before you get dressed.
• Following the treatment, you will talk with the Medtronic representative to check out voiding and bowel diary guidelines and set up contact plans with the agent to go over changes in your urinary and bowel function during the test period.
• You will make a scheduled appointment to see the physician in three to five days in the office before leaving to take off the leads and talk about the results of your trial.

What you want to know about the permanent Interstim implant procedure

Should you experience a greater than 50% improvement in urinary and/or bowel symptoms with your PNE, then you're a candidate for the full Interstim implant device.  This is an outpatient procedure under sedation lasting 15-20 minutes.  The battery and permanent lead is implanted all underneath the skin.  You won't be capable of getting a body MRI after the implant.  A brain MRI however is safe with the Interstim implant.  The battery will last 5-12 years following placement.

If you have any questions concerning the Interstim therapy or anything different associated with bladder issues, schedule an appointment with one of our experienced offices within the St. Louis area, such as Washington, Florissant, and Creve Coeur, MO.