Sacral Nerve Stimulation Therapy for Urge Incontinence and Overactive Bladder
Syndrome While a number of therapies are available to treat the various types of urinary incontinence, many are cumbersome, embarrassing or invasive. When patients can opt for a non-surgical alternative that has a good chance of resolving the incontinence problem, the news is exciting.
Sacral nerve stimulation—also known as sacral neuromodulation therapy—is a simple treatment in which mild electrical impulses stimulate the nerves in the patient's lower back. The stimulation either activates or inhibits the muscles of the pelvic floor, sphincter or bladder, depending on the intended effect. In a nutshell, the device is similar to a pacemaker, except that it stimulates nerves in the lower back instead of the heart.
The patient uses the method for about a week to determine whether a permanent implant is likely to be effective. The treatment is performed on an outpatient basis, and because the initial trial is completely reversible if the effect is not positive, no damage is done. If the response is good, a permanent device is implanted.
Who Can Benefit From Sacral Nerve Stimulation?
Patients whose systems don't respond to simpler procedures are good candidates for this therapy. In general, people who suffer from overactive bladder (OAB) symptoms exhibit the following:
- urge incontinence, in which urine is lost when the person cannot get to the bathroom in time to urinate
- urgency, which is characterized by a strong and frequent desire to urinate
- frequency, which usually entails voiding very small amounts more than eight times in a 24-hour period
- urinary retention, which is the inability to completely empty the bladder.
Is It Safe and Effective?
InterStim®, by Medtronic, Inc., was approved by the FDA in 1999 after extensive clinical trials proved its effectiveness and safety. A number of studies have replicated the research and have found significant positive results in the majority of subjects who had the various types of incontinence listed above.
Resources
Newman, D. (2002). InterStim® therapy: A cutting edge treatment for voiding dysfunction. Seekwellness. Retrieved November 4, 2002, from
www.seekwellness.com/incontinence/interstim.htm#whatis.
Wright, E. J. (nd). Therapy for urge incontinence: Sacral neuromodulation. Retrieved November 4, 2002 at urology.jhu.edu/diseases/bladder/incontinence.html#sacral.
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