InterStim Therapy at a glance
- InterStim Therapy, which treats overactive bladder, urinary incontinence, urinary retention and fecal incontinence, involves sending electrical pulses to the sacral nerves, located in the lower area of the spinal cord.
- The sacral nerves affect bladder and bowel function.
- Of the more than 225,000 patients treated by InterStim for bladder and bowel control therapy, 85 percent achieved success in the first year.
- Before the InterStim device that generates the electrical pulses is surgically implanted, the patient will have a trial period to assure the therapy will reduce condition symptoms.
What is InterStim Therapy?
InterStim Therapy is a reversible therapy that uses an implantable device to send mild electrical pulses to stimulate the sacral nerves. Those nerves control the muscles of the pelvic floor, urinary and anal sphincters, lower urinary tract and colon. The sacral nerves are located just above the tailbone, near the spinal cord.
InterStim Therapy, also known as sacral nerve stimulation or sacral neuromodulation, was approved by the Food and Drug Administration in 1997 for the treatment of specific urinary conditions.
Urology Associates uses InterStim Therapy to treat the following conditions:
- Urinary incontinence: the involuntary leaking of urine due to the loss of bladder control
- Overactive bladder (OAB): the sudden urge to urinate that cannot be controlled
- Urinary retention: the inability to empty the bladder; patients will often feel full but cannot urinate or only release a small amount of urine
- Fecal incontinence: the inability to control bowel movements causing stool to leak unexpectedly from the rectum.
InterStim Therapy is available for patients, most often women, who have not had success with more conservative options like Kegels, pessaries and physical therapy. InterStim is not intended for patients with stress incontinence, urinary blockage, pregnant women, patients with a pacemaker or diabetic patients.
More than 225,000 patients have been treated by this minimally invasive bladder and bowel control therapy. Of those treated, 85 percent achieved success in the first year. That is a three times greater improvement in quality of life compared with medications, according to Medtronic, the developer of InsterStim Therapy.
Inserting the InterStim Therapy device
Since nerve stimulation is not an answer for everyone, there is a test trial period before the InterStim device is implanted. Doctors perform the test phase procedure in an operating room or a medical office. The doctor will numb a small area and insert a thin, flexible needle near the tailbone. This needle will be attached to a wire placed near the sacral nerves.
A small amount of electrical stimulation will test the patient’s sensation to find the best placement. A person can expect to feel a comfortable vibration, pulsing or tingling in the area of the vagina or rectum.
Once the doctor has located the optimal location, the temporary testing wire will be secured and attached to an external battery, which can be placed on the patient’s belt. The patient will have a remote to adjust the level of stimulation. This allows each patient to tailor the device to meet his or her needs.
The testing period will take between 1-3 weeks. During this time the doctor will ask the patient to complete a bladder diary to track daily urinary habits.
If there is improvement in the urinary or fecal symptoms, the second stage of the procedure will be performed to implant the permanent battery in the upper part of the buttock. The battery is similar to a heart pacemaker.
With both procedures, the patient will be able to go home the same day, but will need a driver.
After both procedures the patient should limit activities for 7-10 days. This will allow for the placement of the device to settle, reducing risks. Activities to avoid include:
- Twisting at the waist
- Lifting more than 20 pounds
- Bending from the waist to pick something up; bend from the knees instead
- Reaching high above the head
- Scrubbing floors or vacuuming
- Aerobics or back exercises.
A patient is allowed to do normal walking and go up and down stairs after the procedure. Two weeks after the device is implanted a post-op appointment will check to see that the surgery was successful.
Risks of InterStim Therapy
As with any minimally invasive procedure, patients have a chance of infection, swelling, bruising and bleeding. Pain medication will be prescribed to help with pain and discomfort.
Patients with an InterStim Therapy device will not be able to have an MRI or be subjected to other kinds of diagnostic equipment. If a patient becomes pregnant or is trying to become pregnant, the doctor will need to shut off the device.