Interstim Therapy

InterStim Therapy

InterStim is a treatment option for urge incontinence.  Springfield Urology has been providing this option to patients for many years.  This is a proven treatment option that targets the communication problem between the brain and the nerves that control the bladder.

When to consider InterStim Therapy?

InterStim Therapy is an option for patients who have not had success with, or could not tolerate, more conservative treatment options.  InterStim is not intended for patients with urinary blockage or stress incontinence.  The most common diagnosis that InterStim is used for is Urge Incontinence:

Urge Urinary Incontinence: Patients typically state “I can’t make it to the restroom in time”.  This urge to urinate is caused by an overactive bladder.  At times the patient may leak without warning, these patients typically wear depends or restrict liquids prior to an outing.  

Interstim can also be used for urinary retention that is not a result of blockage such as prostate enlargement.

Urinary retention: Patients typically state, “I feel full but I cannot urinate or I only dibble”.  Retention is the inability to empty the bladder. With chronic urinary retention, you may be able to urinate, but you have trouble starting a stream or emptying your bladder completely.

What is InterStim Therapy?

The InterStim system uses an external device during a trial assessment period and an internal device for long-term therapy.  InterStim Therapy is a proven neuromodulation therapy that targets the communication problem between the brain and the nerves that control the bladder.  If those nerves are not communication correctly, the bladder will not function properly.

What is the trial assessment period?

When your physician decides to try, first you will be schedule to do a trial assessment.  This appointment will take place at Springfield Urology. We do this trial assessment so you can test InterStim without making a long-term commitment.  This is how it works:

  • Your doctor will numb a small area and insert a thin, flexible wire near your tailbone.  The wire is taped to your skin and connected to a small external device, which you’ll wear on your waistband.

  • The external device sends mild electrical pulses through the wire to nerves near your tailbone, which may get your bladder working the way it’s supposed to.

During the trial assessment you can continue many of your daily low to moderate level activities with caution.  You can usually continue to work throughout your trial assessment if you job doesn’t require strenuous movement.  You will be asked to document your bladder symptoms.  You and the physician will use this information to decide if you are a candidate for full internal implantation.

How is the internal device inserted?

Approximately 4-7 days after your trail assessment you will be schedule to return to the office.  During this office visit you and your physician will review your bladder symptoms with and without the device.  If a decision is made to go to the full implant, you will sign consent forms for the surgical procedure.  We will then do an insurance evaluation to confirm that your insurance will pay for the procedure.  The surgery scheduler will call you within a few days to set the appointment at the hospital.

The day of the procedure, you will be required to follow the pre-surgery instructions provided by Springfield Urology.  You will be given general anesthesia, so a driver is required to accompany you to the hospital.  You will be allowed to go home that same day.  You will notice immediate changes in your urinary symptoms, but this system is programmable.  This program can be adjusted during a visit to Springfield Urology.  You will be given an appointment for a post-op appointment within two weeks after your surgical procedure.

What should you do if your device stops working?

Please call the office immediately.  Our staff will assist with the following problems.

If you are still in the trail assessment phase please check:

  • If the machine is on.

  • Try turning the machine off for 5 seconds and then

  • Check the battery life.

  • Try changing the battery.

If you have the full implant:

  • If you are unable to feel the leads.

  • You will lose the sensation of the leads, therefore only be concerned if your symptoms increase.

You may be asked to schedule an appointment to review the program.  If this is the case then we will ask that you do a voiding diary for two days prior to the appointment.  

What are the risks of long-term InterStim therapy?

Complications may include pain at the implant site or new pain, infection or skin irritation, lead (thin wire) movement/ migration, device problems, interaction with certain other devices or diagnostic equipment such as MRI, among others.  Please discuss complications with the physician prior to any decision.

**Information provided by the Medtronic Company.  Please visit www.medtronic.com/oab for more information.

 

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