What is InterStim Therapy for Urinary Control?

Medtronic InterStim^® System for Urinary Control is indicated for the treatment of overactive bladder and urinary retention, including urge incontinence and significant symptoms of urgency-frequency. InterStim can work for patients who have failed or could not tolerate more conservative treatments.

InterStim Therapy uses a small device to send mild electrical pulses to a nerve located in the lower back (just above the tailbone). This nerve, called the sacral nerve, influences the bladder and surrounding muscles that manage urinary function. The electrical stimulation may eliminate or reduce certain bladder control symptoms in some people. The system is surgically placed under the skin in an outpatient setting using local anesthesia.

Types of Bladder Control Problems

You may be one of millions of people who experience frustrating and embarrassing bladder control problems. These conditions, which prevent you from controlling when and how much you urinate, can make simple, everyday activities a challenge and social lives very difficult.

There are different types of bladder control problems and some people have more than one type. InterStim Therapy does not treat every type of bladder control problem.

You should be able to identify the type of bladder control problem you have by comparing your symptoms with the lists below.

Urinary Urge Incontinence

If you suffer from urinary urge incontinence, you may:

• Have been diagnosed with overactive bladder.
• Lose urine as soon as you feel a strong need to go to the bathroom.
• Leak urine when you drink even a small amount of liquid, or when you hear or touch running water.
• Have frequent leaking episodes.

Significant Symptoms of Urgency-Frequency

With symptoms of urgency-frequency, you may:

• Have frequent, uncontrollable urges to urinate.
• Go to the bathroom more often than normal (more than seven times a day).
• Feel that your bladder is never completely empty.

Nonobstructive Urinary Retention

If you have retention, you may:

• Need a catheter to pass urine.
• Spend a long time at the toilet, but produce only a weak, dribbling stream of urine.
• Leak urine (sometimes called overflow incontinence).
• Not have a sensation of when your bladder is full.

Other Bladder Control Problems

InterStim Therapy does not treat symptoms of stress incontinence. People with stress incontinence lose urine when they exercise or move in a certain way. If you have stress incontinence, you may leak urine when you sneeze, cough, or laugh, or when you get up from a chair. You may also go the bathroom often during the day to avoid accidents.

InterStim Therapy is not intended for patients with mechanical obstructions such as benign prostatic hypertrophy, cancer, or urethral strictures.

InterStim Therapy has not been studied in pregnant patients, pediatric patients, patients with diabetes, or patients with multiple sclerosis.

 Self-Assessment Survey

(Click HERE for a printer friendly version of survey)

This self-assessment survey may be helpful in determining whether you have bladder control problems that might be treatable with InterStim Therapy. If you answer "yes" to most of these questions, you may want to discuss InterStim Therapy as a potential treatment.

Please remember that only your physician can determine whether you might be a good candidate for this therapy. You may want to print this page and bring it to the office to discuss with Dr. Wolpmann.

Elaine

Urgency-Frequency Patient

The following profile recounts the experience of one patient who is receiving InterStim® Therapy for the treatment of urinary urgency-frequency. Medtronic invited her to share her story candidly. As you read it, please bear in mind that the experiences are specific to this particular person. Results vary; not every response is the same. Talk to your doctor to determine if InterStim Therapy is right for you.

“When I realized I had to go, I knew I must go immediately, and 75 percent of the time I didn’t make it. I always had to make sure there was a bathroom where I was going and carry pads in case of leaks. It was such a burden.”

My name is Elaine, and I’m a 64-year-old child support officer, wife and mother. About 10 years ago, I began experiencing some urgency, but I’d had four children, so I just assumed I’d have bladder problems eventually. However, it got worse. I was going 18 times per day and three or four times per night.

The bathroom was halfway down the hall from my office. I remember ducking into an empty office, crossing my legs, trying to hold it back. I’d leak a little and often as soon as I started walking, I’d leak a lot. Thank goodness for the bathroom blow dryers—I’d use them to dry my clothes. I tried not to get too close to other people at work, because I was afraid I’d smell. In court, I wore pads because it was so long between breaks.

My family doctor prescribed exercises, which didn’t work. Next, I saw a urologist, who gave me bladder medication. However, soon after I started the drug, I was diagnosed with breast cancer and began treatment. The combination of cancer and bladder medications made my tongue literally stick to the roof of my mouth, so I discontinued the bladder medication.

After my cancer treatment, my urologist referred me to his colleague. He did a number of diagnostic tests before he suggested InterStim Therapy. Then, in the fall of 2004 I did a test of InterStim Therapy to see if it worked for me. My symptoms did improve, but weren’t completely gone. I was implanted in December 2004. InterStim Therapy gradually helped. It took some adjustments until it was working well, but then suddenly it started working fine. It’s been fine for the last nine months.

Now I go about five times during the day, maybe twice in the evening. I don’t get up at night, I’m done leaking and I no longer wear pads. I feel like I’m free of something very burdensome. Even when I didn’t know if InterStim Therapy would work, I was bound and determined to make it work, because I didn’t want to go back to how I had been. I’d definitely say give it a try; it’s not for everybody, but the freedom was worth it.

Jayne

Urgency-Frequency Patient Story

The following profile recounts the experience of one patient who is receiving InterStim® Therapy for the treatment of Urgency-Frequency. Medtronic invited her to share her story candidly. As you read it, please bear in mind that the experiences are specific to this individual person. Results vary; not every response is the same. Talk to your doctor to determine if InterStim Therapy is right for you.

"I can't tell you how many times doctors have told me, 'It's all right, Honey' or 'It happens when you get older. What do you expect?' But having to urinate 47 times in a 12-hour period is not all right. And there's more to life than touring every public bathroom in San Luis Obispo.

My name is Jayne. In 1997, when I was 53 years old, I began experiencing urinary frequency and urgency. On a typical day I averaged 47 trips to the bathroom between 7 am and 7 pm. I made a point not to count how many times I got up at night—knowing would just make me feel worse.

I tried many medications, but nothing helped. I carried pads and a change of clothes wherever I went. Eventually I couldn’t go out. The only good thing about being home all the time was it gave me time to finish my rabbinical studies. Finally in 1999, I spoke with a woman who also had bladder control problems, and recommended I visit her doctor.

This doctor had just learned about InterStim Therapy and after evaluating me, she suggested I try it. Within 20 minutes of starting the test stimulation, I knew something was different. That one-week test felt like pure heaven. I could hardly bear for it to be taken out while I waited for the implant surgery.

InterStim Therapy is life-altering. Now I go 6 or 7 times during the day and I sleep through the night. It’s wonderful to be with my children and grandchildren and be part of their lives. I can go shopping with them and attend games where my granddaughter is cheerleading. In my work as a rabbi, I drive all over seeing hospice patients—something I never could have done before. I feel more confident because I no longer worry about leaking or smelling like urine. If I have a long service to perform or expect to be in a stressful situation, I turn up my stimulation, and it’s reassuring to know I’ll be fine. InterStim Therapy has been life-changing for me—it’s amazing. I would definitely advise others to try it.”

Jeannie

Urgency-Frequency Patient Story

The following profile recounts the experience of one patient who is receiving InterStim® Therapy for the treatment of Urgency-Frequency. Medtronic invited her to share her story candidly. As you read it, please bear in mind that the experiences are specific to this individual person. Results vary; not every response is the same. Talk to your doctor to determine if InterStim Therapy is right for you.

I remember one particularly miserable moment. My family and I were vacationing in the Bahamas, and there was water everywhere: pools, waterslides, and of course, we were surrounded by water. It was a nightmare for me. I could hardly leave the room, because I had to go to the bathroom all the time, and I worried that I was ruining the family's trip. I was at my wit's end.

My name is Jeannie. I'm a 50-year-old wife, mother, and a pre-op day surgery R.N. I'm also a patient who has struggled with urinary control problems for years until I found a treatment that completely changed my life.

In 2000, I began experiencing urgency and frequency. As a R.N., I knew something was wrong, so I went to see a urologist I knew from the hospital where I worked. He prescribed every urinary control drug there is, but none of them helped. I changed my diet and I tried over the counter medications. Nothing made a difference. I still had to go every 15 minutes during the day. At work I often had to make a mad dash for the bathroom between seeing patients. At night, I got up to go every hour. I felt like something out of "The Night of the Living Dead" every day. I'd go to work and then come home and crash. My urinary control problem was disrupting work and my time with my family.

After we tried all the other options, my doctor suggested InterStim Therapy. In early February of 2003, I underwent test stimulation. Since that was successful, we went ahead with the system implant. All was well until one of my coworkers accidentally crashed a stretcher into my back, right where the system battery was implanted. In August 2004, I had another surgery to replace the system, since the battery was dislodged. Now I go every four hours during the day and I only get up once at night. I'm not sleep-deprived and I've begun working out again. My daughter and I love horseback riding and are taking hunt-seat jumping classes. I feel like I've been given my life back.