Overactive Bladder (OAB) is a common condition characterized by a sudden, often overwhelming urge to urinate, which may be difficult to defer. This urge can be accompanied by frequent urination, both day and night, and sometimes even urge incontinence, the involuntary loss of urine. When conservative treatments do not provide sufficient relief for these disruptive symptoms, InterStim therapy offers an alternative approach. This therapy aims to manage OAB by modulating nerve activity associated with bladder control.
Understanding InterStim Therapy for OAB
InterStim therapy, specifically sacral neuromodulation, addresses symptoms of Overactive Bladder by targeting the sacral nerves. These nerves, located in the lower back, play a significant role in regulating bladder and bowel function. The therapy involves delivering mild electrical pulses to these specific nerves.
The mechanism behind InterStim therapy involves normalizing the communication pathways between the brain and the bladder. When these signals are disrupted, the bladder may contract inappropriately or send incorrect messages to the brain, leading to OAB symptoms. By modulating the sacral nerves, the therapy helps to restore more appropriate nerve signaling, which can reduce the frequency and urgency of urination.
Determining Candidacy for InterStim
Deciding if InterStim therapy is a suitable option involves a thorough evaluation by a healthcare provider. Individuals are considered for this therapy when less invasive treatments have not provided adequate relief for their Overactive Bladder symptoms. This includes conservative approaches such as lifestyle modifications, bladder training exercises, or oral medications.
A healthcare professional will review an individual’s medical history, including any previous treatments for OAB and their outcomes. They will also assess the nature and severity of the OAB symptoms. This evaluation ensures that InterStim therapy is a medically appropriate and potentially beneficial course of action.
The InterStim Implantation Process
The InterStim implantation process involves two stages, allowing for an evaluation period before a permanent device is placed. The first stage is a temporary evaluation, known as a test phase. During this period, a temporary thin wire, or lead, is placed near the sacral nerves under local anesthesia and connected to an external neurostimulator.
This temporary setup allows the individual to experience the therapy for several days to determine if it effectively reduces their OAB symptoms. If the test phase demonstrates a significant improvement in symptoms (at least a 50% reduction), the individual may proceed to the second stage. The second stage involves a minor surgical procedure to implant the permanent InterStim device, a small neurostimulator, under the skin in the upper buttock area. This device is then connected to a permanent lead positioned near the sacral nerves. The permanent implantation is performed as an outpatient procedure, allowing the patient to return home the same day.
Life with an InterStim Device
Living with an implanted InterStim device involves ongoing management and adjustments to optimize therapeutic benefits. Individuals have routine follow-up appointments with their healthcare provider to program the device settings. These programming adjustments fine-tune the electrical pulses to ensure maximum symptom relief and comfort.
The implanted neurostimulator contains a battery with a lifespan that varies depending on the model and usage, lasting between 5 to 10 years. When the battery depletes, a replacement procedure is required, which is a minor outpatient surgery to exchange the device. Most daily activities can be resumed after implantation, though certain medical procedures, like full-body MRI scans, may require specific device models or settings. Patients also learn how to manage the device using a handheld programmer and are advised on considerations regarding security scanners.