InterStim® Sacral Neuromodulation is a clinically proven, FDA approved (since 1997) therapy for management of Refractory OAB (Overactive Bladder), Incomplete Bladder Emptying (not due to outflow obstruction), and Fecal Incontinence (the latest since March 2011).
This particular therapy targets the communication problem between the brain/body and the nerves that control bladder and/or rectal/anal functions. When these nerves do not communicate properly, the bladder and or rectum/anus malfunctions.
It first involves the use of an external device during a trial assessment period (called peripheral nerve evaluation, or “PNE”). Once acceptable symptom relief is achieved following the PNE, the permanent internal device – commonly referred to as the bladder pacemaker – is placed.
Is InterStim the Right Therapy for Me?
First, your urogynecologist will have to determine if you are a candidate for the therapy and if all criteria have been met. With the PNE, we can assess how well the therapy will work for you before you make the long term commitment (a “test drive”).
The PNE is typically done in the physician’s office. The skin and underlying structures around your tail bone will be adequately numbed. With the aid of X-ray vision, two flexible, tiny hair-sized wires called “temporary leads” will be placed under the skin close to the nerves’ supply and the bladder. The wires will be attached to an external pulse generator/stimulator which will provide constant stimulation of these nerves. You will go home with the device for 3 to 5 days. There will not be much disruption or restriction of your everyday activities during this time. During this test period, you will be asked to keep a bladder diary to help us assess your symptom improvement.
If you experience at least 50% or greater improvement of your urinary and/or fecal symptoms, you are a good candidate for the permanent therapy.
The permanent therapy is usually performed in a hospital operating room. It is similar to the PNE in terms of lead placement (the exception being that the lead used now will be a permanent lead). On the contrary, you will have a permanent pulse generator /stimulator which will be buried deep in a pocket created by the surgeon around the cheeks of the buttocks, and this part of the procedure is carried out under mild general anesthesia and is painless.