Using Interstim Therapy To Treat Bladder and Bowel Incontinence

Interstim Therapy was FDA approved in the late nineties to treat 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 quantities of urine
• Urinating frequently
• Urinating urgently
• Waking up at night to urinate
• Incapacity to totally empty the bladder, or may be unable to urinate at all (retention)

Exactly what are bothersome bowel symptoms?

• Fecal leakage
• Fecal smearing
• Diarrhea
• Constipation

Just how prevalent are urinary control issues?

• Over 33 million people (1 in 6 adults) suffer from urinary control issues within the United States alone.
• These problems may impact men and women.
• It might affect people of all ages; it is not simply a normal aspect of aging.

Just how prevalent are bowel control problems?

Over 18 million people or 8.3% of adults endure signs and symptoms of bowel control.
In fact, this affliction is very likely more widespread than reported as a result of the uncomfortable nature of the condition.

Exactly what are the factors behind bothersome bladder and bowel symptoms?

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

How would I know if Interstim Therapy is right in my situation?

You need to visit 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 ten straight years since the year 2007, concentrates on the management of bothersome bladder and bowel symptoms and has one of the greatest experiences with Interstim Therapy in Missouri.

Interstim Therapy has 2 phases:

• Test trial period to determine if the treatments are right for you—Percutaneous Nerve Evaluation (PNE)
• Permanent Interstim Implant

Before placement of the permanent implant, your doctor may suggest a Percutaneous Nerve Evaluation (PNE). PNE is an easy office test which gives you an opportunity to test two temporary leads (or wires) within the pelvic nerves.  Using local anesthesia in an office setting, two temporary leads are put on each side of the pelvic nerves.  The leads are taped to the rear and connected to an external battery the size of a beeper.  The patient will have the opportunity to test both leads within the next three to five days to determine if there are any alterations to the bladder or bowel symptoms.  We consider a 50% improvement in symptoms a positive test, making the individual a candidate for implantation of the permanent device.

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

• Please get there half an hour prior to your slated meeting time.
• You might drive yourself to the procedure; nevertheless, it is much better to have somebody drive you to and from the procedure.
• This procedure is completed in the office under local anesthesia within 10-15 minutes.
• A light snack or meal is okay two hours before the procedure.
• Get rid of aspirin and ibupfren products (Motrin, Alleve, etc) for no less than five days prior to your procedure.
• Let our scheduler know whether you are taking blood thinners, such as Coumadin (warfarin), Xaralto, etc.
• No baths or showers are allowed during the test period.  You can take sponge baths and clean your hair in the sink.
• Refrain from heavy lifting or excessive bending throughout the trial.
• If you aren't able to tolerate the PNE, there's also an option to carry out the trial phase in the operating room with anesthesia.  This is known as a "Stage 1" procedure. You and the physician will decide if a Stage 1 procedure is appropriate for you.

What you need to expect on the day of the PNE procedure

• You will meet a medical assistant and representative(s) from Medtronic; the device company.
• You will be directed to lay on your stomach.  The medical assistant will wash your back and buttocks.
• Your doctor will perform the procedure with the aid 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 procedure, you are going to consult with the Medtronic representative to review voiding and bowel diary guidelines and set up contact plans with the representative to talk about changes in your urinary system and bowel function during the trial period.
• You'll make an appointment to see the doctor in 3-5 days in the office prior to leaving to take away the leads and talk about the outcomes of your trial.

What you should know regarding the permanent Interstim implant procedure

If you experience a greater than 50% improvement in urinary or bowel symptoms with your PNE, then you're a candidate for the full Interstim implant device.  This is an outpatient process under sedation lasting 15-20 minutes.  The battery and permanent lead is inserted all underneath the skin.  You will not be able to get a body MRI following the implant.  A brain MRI however is safe with the Interstim implant.  The battery will last 5-12 years following placement.

If you've got any queries about the Interstim therapy or anything more related to bladder problems, arrange an appointment with one of our offices in the St. Louis area, such as Washington, Florissant, and Creve Coeur, MO.