GYN Conditions
GYN Surgery
Interstim Therapy
Bladder control problems are estimated to affect more than 13 million Americans every year. Many women are embarrassed by their condition and do not even want to talk to their doctor about it. Bladder control problems are not necessarily a normal part of aging. If the symptoms are significantly affecting your quality of life, then there are treatment options which may be able to help. Urge Urinary Incontinence (UUI) is defined as urinary leakage associated with a feeling of urge to urinate. Many times patient’s leak when they are not able to reach the bathroom quickly. Overactive bladder (OAB) is a common condition affecting 1 in 6 adults. With OAB, the bladder muscle squeezes too often, causing frequent, strong sudden urges to go. As a result, patients experience urinary urgency and frequency and sometimes they can leak urine if they are not able to reach the bathroom quickly.
Overactive Bladder (OAB) with or without Urge Urinary Incontinence (UUI) caused by involuntary bladder wall contractions that may happen randomly and at the least convenient times and locations. The first line of treatment consists of a daily anti-cholinergic medication, such as Ditropan, Detrol, Vesicare, Enablex, Oxytrol, etc. These medications effectively “calm” the bladder wall and decrease urinary frequency and leakage. These medications are contraindicated in women with narrow-angle glaucoma. So tell your doctor if you have this condition. The most common side effects are dry mouth and constipation. The higher the dosage, the more effective the medication is. But unfortunately, the side effects may be more severe as well.
For patients in whom these medications are contraindicated, not working effectively, and/or the side effects are too bothersome; there is an alternative treatment option. Interstim or Sacral Nerve Stimulator (SNS) is a safe and effective device that once implanted usually helps decrease symptoms from OAB and UUI. Interstim, also known as the “bladder pacemaker”, calms the bladder locally. Thus it avoids the systemic side effects of medications. It is a highly effective 0.5 x 2.0 inch size device installed in the “fat” of the buttocks. A wire runs from the device to the sacrum and stimulates the third sacral nerve. The communication between the device and the sacral nerve helps to control the bladder wall contractions. The surgery is usually performed in a minor surgery center or outpatient surgery center under local and light-sedation IV anesthesia. The procedure usually takes about 1 hour. There is one 3 inch incision in the buttock and one small incision in the midline of the lower back. Recovery is short and normal activity is resumed in 1 day. The procedure is performed in two phases. After the initial procedure, for 1-2 weeks, the patient must work with her temporary SNS device to determine which setting works best for her. She must keep a strict diary of her voiding habits. If the device improves symptoms by more than 50%, the device is implanted permanently in the second phase. The battery lasts between five and ten years.
Learn more about Urinary Incontinence and treatment options.