Overactive bladder (OAB), also known as overactive bladder syndrome, is a condition where there is a frequent feeling of needing to void to a degree that it negatively affects a person’s quality of life. The frequent need to urinate may occur during the day, at night, or both. Frequent urination at night is called nocturia. When there is loss of bladder control associated with a strong and compelling urge to urinate it is known as urge incontinence OAB wet. Other patients only have urinary urgency and frequency but do not experience leakage (OAB dry). More than 40% of patients with overactive bladder have incontinence. The condition is chronic. Therefore, most patients have this problem for the remaining of their life.
Mild Electrical Pulses Can Help Bladder Control
If you suffer from any of the symptoms of overactive bladder, you’re not alone. It is estimated that more than 33 million Americans suffer from OAB. If you are not responding to the oral medications (antimuscarinics) or having side effects from them sacral neurostimulation (Interstim) may be an option to help you regain bladder control.
How is Interstim Unique?
The uniqueness of Interstim is that it offers a trial period before the device is implanted. The trial assessment takes 3 to 7 days and lets you try neurostimulation to see if it is right for you without making a long-term commitment. Dr Gousse will help you determine whether neurostimulation is right for you. The treatment is designed to minimize the symptoms of overactive bladder.
How does it Work?
The exact mechanism by which Interstim works is not known. The first stage of the procedure (called peripheral sacral nerve evaluation (PNE) may be performed in the office or the operating room, depending on the case. Dr Gousse will numb a small skin area and insert a thin, flexible wire in your sacral nerves (near your tailbone).
During the PNE, you will be awake in order the guide proper placement. You will be asked where you feel the nerve stimulation in your body. Dr Gousse will also note some muscle contractions in your body to guide proper placement. Typically, you will be in the prone position (lying on your stomach). This position allows access to the tail bone and anal area.
Once proper placement is confirmed, the electrical wire is taped to your skin and connected to a small external stimulator (resembling a large beeper) which you’ll wear on your waistband.
The external stimulator sends mild electrical pulses through the wire to a sacral nerve. Electrical shock or severe nerve damage associated with the therapy has virtually never been reported. The stimulation may help improve your bladder function or get it working the way it’s supposed to.
During the trial assessment, you can continue many of your daily activities with caution. You can usually continue to work throughout your trial assessment if your job doesn’t require strenuous movement. You’ll be asked to document your urinary symptoms which led to the implant. If your symptoms are significantly reduced or eliminated during the trial, you and Dr Gousse can discuss long-term neurostimulation therapy. Dr Gousse or nurse will give you information about operating the test stimulator. He or she will also tell you about any precautions or activity restrictions related to the trial assessment.
Long-term sacral nerve stimulation therapy involves placement of an implantable pulse generator-battery (the size of stop watch) under the fatty tissues of the upper buttock area. Typically this step (step 2, battery implant), done only after the trial test (step 1) is shown to be successful, is performed in the operating room under local or general anesthesia. The half life of the battery varies according to usage and type and may last 3 to 8 years. Once the entire system is in place, there are no visible wires or batteries outside of the body. One can regain a normal life without limitations. A few patients may experience discomfort at the battery implant site.
