Bladder problems can be embarrassing and devastating. In many cases, loss of urine or bowel control can significantly disrupt daily life as people with these disorders avoid travelling, going to the gym and attending social gatherings. Fortunately, we’re excited to be at the forefront in treating bladder issues with a Sacral Neuromodulation (Interstim) – a well-established treatment for individuals who suffer in silence.
Bladder is a hollow balloon-like organ, located in the lower abdomen as part of the urinary system, to accumulate urine. As one gets older, the bladder changes, losing its elasticity, stretch and ability to hold as much urine as before. This resultantly increases the frequency of trips to the bathroom. At the same time, the bladder wall and pelvic floor muscles start getting weaker, making it more difficult to empty the bladder completely and causing urine to leak.
However, even in a very young age the bladder function can be disturbed – most of the time it is not possible to determine the root cause of the problem. As a matter of fact, around 17% of all younger females experience this problem, with no other medical condition but just the frequency and urgency of urination.
Under normal circumstances, the brain controls the function of the urinary bladder by sending signals through the spinal cord to the sensory nerves of the bladder, which further control the bladder muscles and determine the activities (contraction and relaxation) of muscles to fill, retain and finally release urine.
When the bladder is full, the sensory nerves communicate to the brain. As a result, the brain generates signals to evacuate the urine, causing a sensation to void. In case the sensory nerves receive false signals, they can cause urinary frequency and urgency although the bladder isn’t full yet or even almost empty. This condition might get very annoying for the patient – some people feel the sensation to urinate every 15 minutes without being able to control or suppress the feeling. This is called “sensory overactivity”. In case, the bladder even starts contracting and evacuating the urine without control it is called “motoric overactivity”. The condition can become severe, in any way, the quality of life is affected. That is why patients need help.
Bladder problems are common among both men and women. Common bladder problems that patients complain of include:
Generally, medication is the first line of treatment for patients with urinary problems to manage their symptoms. Most of the time, this works well, at least for a certain while. But in some cases, when symptoms don’t respond to conservative treatment or the medication has been exhausted, alternatives are needed.
The opposite problem does exist as well – the patient is unable to empty the bladder since it doesn’t contract completely or not at all. As a result, urine remains in the bladder and some patient do even have to catheterize themselves in order to drain the urine. There is no medicine for an “under-active” bladder to restore it’s function.
Even if the medicine is effective some patients don’t come along with it well because of side effects. In fact, it is well known that almost half of the patients do discontinue the regular medicine for the bladder since they have got tired of side effects.
Sacral Neuromodulation treatment works by re-training and re-educating the sensory and motoric nerves of the bladder and help to restore urine control, in either way.
Due to its high rate of effectiveness in improving the symptoms, it has been considered a top choice for the treatment of Overactive Bladder (OAB), Urinary Incontinence as well as urinary retention.
Sacral neuromodulation comes with very tiny leads, like small wires, which are placed alongside one of the main nerves in charge for the bladder control. The wires are connected to an “impulse generator” (battery), a small device similar a pacemaker for the heart where the electricity comes from. The battery is implanted in the buttock and emits a continuous, mild electrical pulse that helps stimulate sacral nerves and correct the bladder function.
Generally, Sacral Neuromodulation is advised to patients who have not achieved any improvement from conservative treatment options (such as medications). The treatment has proven effective in providing immediate yet long-term relief from symptoms associated with urinary disorders.
After an evaluation of your symptoms for the Sacral Neuromodulation, your Urologist will discuss with you the procedure and its pre-requisites, which involve two stages, testing and implantation. For the first step, a small wire is placed near the third sacral nerve from the lower back in a very minimally invasive way under fluoroscopy control. It is connected to an external battery, the “impulse generator” which has multiple settings to stimulate the bladder in the way which is the best for the individual patient.
The patient is advised to test and monitor the performance of Sacral Neuromodulation at home for 1 to 2 weeks. In case there is a significant improvement of symptoms, and the patient feels a benefit the permanent electrode and battery will be implanted. Otherwise, the test wire is removed, and it is done.
Since it’s a minimally invasive procedure, it has speedy recovery time, causes minimal or no discomfort, and requires approximately 30 -60 minutes.
We have board-certified urologists who are working in an interdisciplinary team to treat patients with various urinary problems including urinary urgency and frequency, urinary incontinence and difficulty emptying the bladder. If you suffer from bladder issues or need a second opinion on the management of bladder disorders, we invite you to schedule a consultation by filling out our secure web form below.