InterStim therapy is a reversible therapy used to treat urinary incontinence, frequency and incomplete bladder emptying. An implantable device is used and sends mild electrical pulses to the sacral nerves. Located near the tailbone, the sacral nerves control the bladder and the muscles related to urinary function. If the brain and sacral nerves don’t communicate correctly, the nerves can’t tell the bladder to function properly. This communication problem can lead to symptoms of overactive bladder. The Interstim device works like a pacemaker to keep signals moving to the bladder to keep your urinary system “awake”. While it is used slightly more often for women, men also benefit from an InterStim procedure. It is also used for fecal incontinence in cases like Crohn’s Disease.
Women’s Health Concerns
How Does It Work?
Sacral Nerve Stimulation (SNS) is a minimally invasive surgical option that involves the implantation of a small medical device to stimulate the sacral nerve. The InterStim device was developed by Medtronic, and was approved for use by the U.S. Food and Drug Administration (FDA) in 1997.
The InterStim device sends mild electrical pulses to the sacral nerves located just above the tail bone. The sacral nerves activate or inhibit muscles and organs that contribute to urinary control. These include bladder, sphincter and pelvic floor muscles. This electrical stimulation is designed to facilitate communication between the brain and the bladder in order to eliminate, or reduce, certain bladder control functions.
InterStim is not a therapy that is not widely talked about, because most men and women who use this technology don’t readily share the info. However, InterStim is not new. Millions of people have used this same type of “pacemaker” to keep various nerves “awake”. This this case, we modulate the sacral nerves to alleviate constant trips to the bathroom. In other words, when the sacral nerve is “awake”, it does the job it’s supposed to do!
What To Expect
Before starting InterStim therapy, we’ll conduct two tests to determine if this therapy will be effective for the patient. Likewise, you’ll give the doctor feedback on your trials as you go so that he knows how best to adjust.
This is an in-office procedure in which temporary leads are placed into the sacral nerve using a local anesthesia. After the leads are placed, a test will be performed to insure that the sacral nerve is being stimulated. This can be easily verified by the movement of the big toe. Regardless of overall test outcomes, these leads will be removed in the office after one week.
This test is performed in the operating room on an out-patient basis. This is generally indicated for patients who have urinary retention, in which a longer sacral nerve stimulation is necessary. Rather than placing temporary leads, this procedure uses one long-term lead that is left in the sacral nerve for a minimum of two weeks. If the patient is recommended for permanent placement of the InterStim device, this lead will remain in place and be connected to the InterStim after the test period is complete. If the patient is not recommended for the InterStim, they will still require a second surgery to remove the long-term lead.
Implantation of the InterStim device is performed in an out-patient operating room. The doctor will advise the patient which type of anesthesia will be used – pain medication with a sedative or general anesthesia. During the procedure, two incisions will be made in the buttocks. The device will then be placed under the skin. The incision for the neurostimulator will be about 2 inches long; a second incision will be about ½ inch or less.
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