Sacral Nerve Modulation (Interstim)

iStock 000005812265SmallInterStim Therapy for Urinary Control is quite possibly the most effective treatment for urinary urgency and frequency syndromes, with or without urinary leaking, in patients who have found behavioral and pharmacological treatments for incontinence either ineffective or poorly tolerated. The most common of these syndromes is “overactive bladder,” but “interstitial cystitis” and others may fit into this category as well. It is also effective for urinary retention secondary to pelvic floor spasm. The therapy is based on the observation, over years of research, that electrical stimulation of sacral nerves can influence the behavior of the bladder, sphincter, and pelvic floor.

InterStim Therapy for the reasons above is covered in all 50 states and Puerto Rico by Medicare, and by nearly every private insurance company.

How do I know if I’m a good candidate for Interstim?

You can know, within a week, if you are a good candidate.

Before placing an Interstim, we usually start with a simple “percutaneous test” to see if you would respond well to an Interstim device. This is a simple test and lasts about 3-4 days. That way, you can see how it might work for you without committing at this point to a long term treatment. No incisions are involved, and the procedure can be done in the office or in an ASC or outpatient surgical center.

If you have a great response, (50% improvement or more) you are a good candidate for an Interstim. Sometimes you may still be a good candidate for an Interstim even if you don’t have a good response to the simple initial test. About 30% of people who do not have an adequate response to a perc test, may still be a good candidate for Interstim. If your provider feels it is appropriate, s/he may recommend what is called a “Stage 1 trial”. This is a more intense test than a perc test – we actually place the lead that would be used permanently next to the nerve, but instead of using an Interstim pulse generator, we still connect it to an external pulse generator. If you have a good response, it is simple to go on and place the Interstim device. If you do not, the small test lead is easily removed.

See how Interstim works

If you have a good response to a trial assessment (either “perc test” or Stage 1 trial), and decide to go on and have an Interstim implanted, the procedure is fairly straightforward. A small incision is made, and the pulse generator is placed in the subcutaneous tissue in the buttock, above the area that you actually sit on. You will be able to feel it if you press hard, but it will not be readily visible. The pulse is controlled through a wireless device that you carry with you to adjust the settings and turn it up or down as you need to. Typically the batteries in these devices last several years.

The device can be removed at any time. Neuromodulation can dramatically reduce symptoms for many people, but is not a cure for these conditions. If and when the device is removed, you typically go back to your original symptoms. For these reasons, Interstim is usually used as a long term treatment. Interstim can make a significant impact on your quality of life.

Medtronics actually has a volunteer Patient Ambassador program, and you can talk to other patients who have had this procedure, so you know what to expect. Call 1-800-664-5111, ext 3017 to speak to someone who has received Interstim therapy and volunteered to speak to other potential patients.

 

To see some testimonials of patients who have been helped by this procedure, you may also view the video below.