'Pacemaker' Device Helps You Regain Bladder Control

By Gina Garippo

Some people with overactive bladder try treatment after treatment, but nothing seems to work. Others find certain treatments difficult to tolerate. Don't lose hope! A new treatment, called neurostimulation, may be worth considering.

Neurostimulation is a way of controlling urinary incontinence, frequency, and problems emptying the bladder. It works by sending mild electrical pulses to the sacral nerves—the nerves in the lower back that help control bladder function. The treatment requires only an outpatient procedure, and results can be seen quickly.

The Bladder "Pacemaker"The therapy, provided by FDA-approved Medtronic InterStim® Therapy for Urinary Control, works similarly to how a pacemaker helps regulate the heart. A small device is surgically implanted under the skin close to the tailbone. It's programmed to emit electrical pulses that interrupt poor communication between the brain and sacral nerves. Without clear communication, the body is unable to store and void urine correctly.

By regulating communication between the brain and bladder, neurostimulation can reduce urinary leaking and urgency feelings. In clinical trials, the therapy has been shown to eliminate or greatly decrease bladder-control symptoms in people who couldn't tolerate or failed to improve with other, more conservative treatments, such as lifestyle changes or medication.

Reversible TreatmentNeurostimulation isn't permanent. In fact, doctors can remove or simply turn off the system at any time. And it does not cause harm to the nerves. A hand-held programming device allows the patient to adjust the strength of stimulation. This device sends radio signals through the skin to the neurostimulator.

A Pre-Surgery TestWhat if you're interested in the device but leery of committing to surgery? You can test its effectiveness before having the surgical procedure. During this trial period, the doctor numbs your lower back and inserts a thin wire near the sacral nerves. The wire leads to a stimulator, which is worn on your waistband during the trial. The stimulator sends mild pulses through the wire to the sacral nerves.

The trial period lasts three to seven days. During this time, patients keep a diary of urinary symptoms. If there is a significant improvement, they may consider having the device implanted for ongoing use.

Talk with Your DoctorNeurostimulation isn't right for everyone. Some people with the device have experienced negative side effects. These include:

• Pain at the implant site
  
  
• Infection or skin irritation
  
  
• Wire movement
  
  
• Changes in bowel or urinary function
  
  
• Unpleasant feeling of stimulation
  
  

If you'd like to explore neurostimulation, discuss it with your doctor.