Bladder "Pacemaker" To Improve Quality Of Life For Incontinence Patients

What is InterStim� Therapy Treatment?

InterStim� Therapy, sometimes referred to as sacral neuromodulation therapy, is a reversible treatment that uses mild electrical pulses (called electrical stimulation) to stimulate nerves in your lower back, just above the tailbone. These nerves are called sacral nerves. The sacral nerves (specifically S2, S3 and S4) activate or inhibit muscles and organs that contribute to urinary control -- the bladder, sphincter and pelvic floor muscles.

Approximately 80% of patients who undergo the procedure are experiencing a relief of symptoms.

The InterStim� Therapy is a two-stage procedure that includes a test stimulation, surgical implant and post-implant follow-up.  For the test phase, the patient wears an external stimulator for approximately one to two weeks that sends mild electrical pulses to the sacral nerve via a lead that is implanted under the skin.  If the trial is successful in reducing or completely eliminating their leaking episodes, a permanent neurostimulator is implanted.

Because the lifespan of the neurostimulator batteries is 8-15 years, there are few necessary interventions following the procedure.  The Interstim� Therapy is completely reversible an can be removed at any time with no damage to the nerves.

Who is the best person to receive the InterStim� Therapy treatment?

Many people have chronic, debilitating symptoms of voiding dysfunction that are refractory (do not respond) to standard treatments. Refractory voiding dysfunction is often under-acknowledged, may affect a large number of people and has been proven to be difficult to treat. This type of bladder dysfunction can have a debilitating impact on a person's social and personal life, so effective therapy carries great potential for life-changing benefits.

Usually these persons suffer from overactive bladder (OAB) symptoms, which include urge incontinence, urgency, frequency (referred to as urgency/frequency syndrome) or urinary retention. These symptoms may not have responded to medications or dietary changes and would justify Interstim� Therapy.

What problems can occur with this treatment?

As with any surgery, problems can occur.  You can get an infection at the site.  Pain can occur at the stimulation/implant site and/or lead site.

Will my insurance cover InterStim� Therapy?

Probably yes, as most major private insurers are covering this treatment. Medicare will cover sacral nerve stimulation for the treatment of urinary urge incontinence, urgency-frequency syndrome and urinary retention if the following criteria are met:

• Documented failure to conventional therapy (drug, behavioral)
• Persons with stress urinary incontinence, urinary obstruction and specific neurological diseases (diabetes with nerve involvement) that are associated with secondary manifestations of the above three indications are excluded.
• Person must have a successful test stimulation (Step 1) or a successful staged lead implant in order to support implantation and the person must demonstrate a 50 percent or greater improvement in Step 1 as measured through Bladder Records.
• Person must be able to complete Bladder Record data so that implant procedure outcome can be evaluated

What should I do if I think I may be a candidate for the InterStim� Therapy?

If you would like more information about InterStim� Therapy, or if you think you might be a candidate for this therapy, talk with your urologist or urogynecologist. You may also receive additional information about InterStim� Therapy directly from Medtronic. Medtronic, the company that manufacturers the InterStim� system, trains all physicians before they can provide this therapy.