What is InterStim Therapy?
InterStim is a Medtronic Bladder Control Therapy used to treat symptoms related to overactive bladder (OAB) for men and women, including:
• Getting up and urinating at least two times per night (nocturia)
• Inability to postpone the need to urinate (urinary urgency)
• Leakage of urine when the urge to urinate occurs (urge incontinence)Urinating at least eight times per day
InterStim Therapy may also be used to treat patients with an overactive bowel, constipation or anal leakage.
With the FDA-approved InterStim Therapy, a stimulation device similar to a pacemaker is used to correct the communication between the brain and the bladder (or bowel). The device sends mild electrical pulses to the sacral nerves––a process known as sacral neuromodulation––that control the bladder, bowel and associated muscles connected to urinary and gastrointestinal function.
How is the procedure performed?
InterStim therapy begins with an evaluation to see if this is the right treatment for each patient.
The evaluation consists of a minimally invasive outpatient procedure that is usually done in the office but can also be performed in the ambulatory surgical center if an advanced evaluation is required.
For the basic evaluation—which uses a temporary lead—Dr. Jones or Dr. Shah will numb a small area of the upper buttock and insert a thin wire near the sacral nerves, located near the tailbone. The advanced evaluation uses a long-term lead that is fully implanted, with one end of the lead inserted near the sacral nerves.
With both types of evaluations, the lead communicates via Bluetooth® to an external neurostimulator that is worn on the waistband like a pager. The neurostimulator generates mild electrical pulses that are carried to the sacral nerve by the lead.
The evaluation period lasts for two to seven days; if the long-term lead is used, the evaluation period may last up to 14 days.
If the evaluation is successful—i.e., symptoms have improved at least 50 percent or more— long-term InterStim therapy may then be discussed.
InterStim Therapy is completely reversible and may be discontinued at any time by removing or turning off the stimulation device.
What are the benefits of InterStim Therapy?
InterStim therapy is designed to alleviate symptoms in patients with OAB or fecal dysfunction when other treatment modalities (e.g., medication, behavioral therapy) have failed.
With InterStim Therapy, patients have reported:
• An improved quality of life
• An increase in the amount of urine produced during bathroom trips
• Dramatic reduction or elimination of incontinence episodes
• Fewer bathroom trips
• Freedom from catheterization
• Relief from abdominal pain (for bowel conditions)
What are the risks and side effects associated with InterStim Therapy?
As with any surgical procedure, risks may include swelling, bleeding and bruising at the surgical site. Infection at or near the site may also occur.
Side effects of InterStim Therapy may include:
• Adverse changes in urinary or bowel function
• Complications with the device
• Interactions with certain other devices or diagnostic equipment
• Pain at the implant site or new pain
• Skin irritation
• Uncomfortable stimulation, such as a jolting or shocking sensation
• Wire movement/migration
It should be noted that issues with the procedure or implant may be resolved with surgery, reprogramming or medication.
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