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Information provided is for educational purposes. Dr. Miklos and Dr. Moore no longer provide Interstim Therapy.

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Sacral Nerve Stimulation

(Medtronic InterStim® Therapy for Urinary Control)

Table of Contents

•  Introduction 
• The Urinary System  
  • How Does the Urinary System Work?   
  • Why Do Some People Have Bladder Control Problems?  
• Sacral Nerve Stimulation (SNS)  
  • What is Sacral Nerve Stimulation Therapy? 
• SNS Therapy: Test Stimulation and Implant  
  • How is the Test for SNS Therapy Done?  
  • Placing the Test Stimulation Lead 
  •  At Home  
  • Your Follow-up Visit 
• How is the Implant for SNS Therapy Done?   
  •  Implanting the SNS Device  
  • After Surgery  
  • Adjusting the Level of Stimulation at Home
     
• Clinical Study Results
  • Problems or Complications 
• Candidates for SNS Therapy  
  • Who Are Candidates for SNS Therapy?   
  • Who Are Not Candidates for SNS Therapy?  
  •  What Other Limitations Apply to SNS Therapy?
•  Is SNS a Cure for Bladder Control Problems?
•  Interstim Therapy Surgical Procedure

Introduction

Millions of people of all ages suffer from bladder control problems such as retention and overactive bladder or even bladder/pelvic pain. Effects of bladder control problems can be devastating. You have probably found that treatments such as drugs, behavior modification, diet changes, pelvic floor exercises or the use of a catheter to empty your bladder did not effectively treat your symptoms. Dr. Miklos and Moore would like you to consider a therapy called sacral nerve stimulation (SNS) through an Interstim® implant. SNS involves the use of an InterStim® device that can be thought of as a pacemaker for the bladder. Dr Miklos and Moore will send you to an expert in this technology if they believe that you are a candidate for the procedure.

SNS therapy is not experimental. InterStim® Therapy (InterStim® is a registered trademark of Medtronic, Inc.), is a sacral nerve stimulation therapy made by Medtronic. It was approved by the U.S. Food and Dr.ug Administration (FDA) in 1997 and has been used successfully to treat tho! usands of patients worldwide.

After you have read about the InterStim® implant therapy, your doctor will help you make an informed decision about whether to proceed with a test to see if sacral nerve stimulation will work for you.

The Urinary System

How Does the Urinary System Work?

To understand how sacral nerve stimulation and InterStim® work, it is helpful to understand how the urinary system works. The urinary system includes two kidneys, two ureters, the bladder and the urethra (see Figure 1). The kidneys remove excess fluid and waste products from the blood and continuously produce urine. The ureters carry the urine to the bladder where the urine is stored. A muscle called a sphincter controls the opening and closing of the urethra (urine flows through the urethra during urination).

Anatomy of the Bladder Control SystemFigure: 1

How Does the Urinary System Work? (Continued...)

When the bladder begins to fill with urine, a message is sent along the sacral nerves to the brain telling the brain that the bladder is getting full (see Figure 2). As the bladder fills, this message to the brain becomes stronger. When the message becomes strong enough, and you decide to urinate, your brain sends a message back to the bladder along the sacral nerves telling the bladder muscle to contract and the pelvic muscles to relax to allow urine to empty from the bladder (urination). Urination is usually under voluntary control. This means that you decide when and where you want to urinate.

Communication Between the Brain and the Bladder: Figure 2

Why Do Some People Have Bladder Control Problems?

Sometimes, the two-way communication between the brain and bladder is disrupted. When this happens, patients may experience symptoms of bladder control problems. For many patients, sacral nerve stimulation through an InterStim® device may restore the communication between the brain and the bladder, therefore reducing the symptoms associated with bladder control problems.

Sacral Nerve Stimulation (SNS)

What is Sacral Nerve Stimulation Therapy?

Sacral nerve stimulation therapy involves delivering an electrical pulse to the sacral nerves (located just above your tailbone) through an InterStim® implant. This stimulation may facilitate the communication between the brain and bladder, and may relieve the symptoms of urinary retention or symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency in some patients. It also may help control chronic pelvic pain and even fecal incontinence as well.

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