Treating Overactive Bladder with Sacral Nerve Stimulation

 

If you have overactive bladder syndrome that has not responded to medications, physical therapy or other conservative treatments, you may be a candidate for sacral nerve stimulation with systems such as Medtronic’s InterStim®. The fellowship-trained urologists at Foothills Urology in Lakewood, Colorado, began using this treatment when it was approved by the FDA in 1998 and have decades of successful experience in the therapy. We can help you understand the benefits and risks of sacral nerve stimulation and whether it is right for you.

What is sacral nerve stimulation?

Sacral nerve stimulation uses a small pacemaker-like device called a neurotransmitter to send mild electrical impulses to the sacral nerve, which helps control the bladder, sphincter and pelvic floor muscles. The neurotransmitter is implanted during a very short outpatient procedure under the skin in the upper buttock area. Once the incision heals and you get accustomed to the device, patients report that they hardly notice it is there.

 

Learn more about how bladder control therapy works

 

Does sacral nerve stimulation work?

A review published in 2000 in the journal Reviews in Urology looking at multiple research studies found that sacral nerve stimulation, in the appropriate patients, is effective at reducing the urge to urinate, urine leakage, and frequency of urinating in at least 50 percent of patients, with some studies showing much higher results. The effectiveness of this technique has improved in the past decade due to advancements in our ability to modulate the electrical impulses specific to each patient.

At Foothills Urology, we use a sacral nerve stimulation system called InterStim that is manufactured by Medtronic. A study 

published in March 2015 in the journal Neurourology and Urodynamics, sacral nerve stimulation was shown to be “a safe and effective treatment for OAB patients with mild to moderate symptoms.”

In a separate clinical study conducted in 2014 by Medtronic, it was found that 59% of patients with urge incontinence who received the InterStim System and completed follow-up with their doctors, had at least 50% fewer leaks per day when compared to the number of leaks before therapy.

If you would like additional information, Medtronic provides a paper that provides a summary of all clinical research on InterStim.

 Am I a candidate for sacral nerve stimulation?

If conservative treatments have not successfully treated your overactive bladder symptoms, your urologist at Foothills Urology will discuss sacral nerve stimulation as a possible option. If you agree, we will perform a 1-to 2-week test stimulation. If the test is successful at markedly reducing your symptoms, we will recommend a long-term implant.

Although the majority of our patients live in the Denver metropolitan area, this is a very quick outpatient procedure that patients throughout Colorado, Wyoming, Nebraska, New Mexico and other areas in the Rocky Mountain region have sought from Foothills Urology.

What is involved in sacral nerve stimulation surgery?

The urologists at Foothills Urology in Golden, Colo., have performed hundreds of sacral nerve stimulation implants and are some of the most experienced in the Rocky Mountain region. Implantation is a minor surgery that we perform on an outpatient basis in the Red Rocks Surgery Center, which is in the same building as our offices at 400 Indiana Street in Golden, Colorado. It takes less than 2 hours to perform the surgery and you will return home the same day.

Following surgery, you may need to see your Foothills Urology physician a few times to adjust the neuromodulation to get maximum benefit in relieving your symptoms.

The small incision will take about two weeks to heal and we recommend limiting activity for four to six weeks to ensure that it is completely healed. You also may experience some pain as your body forms scar tissue around the device. We will provide you with medication, if needed, to control that pain and it will disappear as your body adapts to the device.

For more questions and answers, see Medtronic’s online FAQ section.

Is sacral nerve stimulation permanent and will it need to be replaced?

Sacral nerve stimulation is not permanent. If the device causes any problems or if your condition or lifestyle changes, it can be removed. The batteries in the sacral nerve stimulation device will need to be replaced every 3 to 5 years, depending on usage. When the batteries are replaced, we will also implant a new device.

Is sacral nerve stimulation covered by insurance?

Many insurance companies, as well as Medicare, cover sacral nerve stimulation if conservative treatments have been tried and failed. Your out-of-pocket costs will vary according to your insurance plan. Check with you insurance provider about the details of your coverage.

How can I find out more about sacral nerve stimulation?

You can find additional information about InterStim at a Medtronic website called Everyday Freedom. Medtronic also provides an ambassador program that connects you with other patients who are using the InterStim system.