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 rectal/anal functions. When these nerves do not communicate properly, the bladder and rectum/anus malfunctions.
Before inserting InterStim®, an external device is used 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 put in place.
Is InterStim® the Right Therapy for Me?
First, your urogynecologist will have to determine if you are a candidate for the therapy and whether or not you meet all of criteria for the procedure. The PNE serves as a “test drive,” allowing you and your doctor to assess how well the InterStim® will work for you before you and your physician plan on the permanent implant.
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 that supply the bladder. The wires will be attached to an external pulse stimulator which will provide constant stimulation of these nerves. You will go home and continue with your normal routine while wearing the device for three to five 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 assess your symptom improvement.
If you experience at least 50% or greater improvement of your urinary and fecal symptoms, you are a good candidate for the permanent therapy and your urogynecologist will continue with the InterStim® placement.
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). A permanent pulse stimulator will be buried deep in a pocket created by the surgeon around the cheeks of the buttocks. This part of the procedure is carried out under mild general anesthesia and is painless.
Following the procedure, overactive bladder, incomplete elimination and fecal incontinence symptoms will subside allowing you to enjoy life again without the worry of an unwanted accident.
Uzoma Nwaubani MD
Dr Nwaubani is an American fellowship trained Urogynecologist and Pelvic Reconstructive Surgeon. She obtained her MD degree from the University of Nigeria. She graduated from Ob/GYN residency training at Newark Beth Israel in New Jersey and subsequently completed her FPMRS (Female Pelvic Medicine and Reconstructive Surgery) fellowship at Mouint Sinai hospital. She has the added priviledge of having practiced female pelvic Medicine for the last 19yrs in 3 different continents and has successfully performed hundreds of incontinence and pelvic reconstructive surgery and is well acclaimed in her field.
Dr. Nwaubani’s professional interest include Urogynecological surgery, minimally invasive pelvic surgery, prolapse and incontinence management, Gynecological evaluations and surgery, female pelvic medicine and wellness, menopausal medicine and urogynecological research and education.
Female Continence & Pelvic Surgery Center