An Innovative Therapy to Restore Bladder and Pelvic Floor Function and Comfort
An estimated 15 million people in the United States experience significant urinary frequency, loss of urinary control, and/or unexplained pelvic pain. These symptoms can severely lower your quality of life and often do not respond to medication or traditional surgical treatments.
Kenneth Finkelstein, D.O. and Women’s Healthcare of Illinois offers InterStim or Sacral Nerve Stimulation to patients who suffer the debilitating consequences of bladder and pelvic floor dysfunction. Our ability to improve or eliminate your symptoms is made possible by restoring the function of your bladder and/or pelvic floor through safe, painless modulation of the nerves responsible for bladder and pelvic floor activity.
This is a safe, FDA-approved therapy that has demonstrated 70-80% success rates in significantly improving patients’ functioning and quality of life.
This guide provides
- An overview of the therapy and why it works.
- Information and instructions concerning the test stimulation information.
- Instructions concerning on-going therapy.
What is Sacral Nerve Stimulation?
Medical researchers have known for over 30 years that the sacral nerves control all the functions of the pelvis and its organs. Electrical impulses travel from the brain to the organs and muscles in the pelvis via the sacral nerves. These impulses are responsible for urinary and fecal elimination, muscle coordination, reproduction organs and the genitals.
Sacral Nerve Stimulation is the introduction of gentle, soothing stimulation or pulsing just below the surface of the skin over the sacrum where the sacral nerves reside. The stimulation is provided by an implanted unit the size of a silver dollar. The unit is placed underneath the skin so as not to place limitations of any kind on the activities of the patient.
Why does it Work?
Scientists have discovered that the exquisite coordination of organs and muscles in the pelvis necessary for normal, pain-free function can become disrupted by any number of events. For example, bladder infections, child birth, hysterectomies, bowel and bladder surgeries, genetic predisposition or almost any other pelvic event can be an insult to the sacral nerves. The insult may lead to faulty nerve impulses traversing the nerves causing pelvic floor dysfunction, urgency frequency and pelvic pain.
The mild stimulation provided by the Sacral Nerve Stimulator serves to correct the communication signals to the sacral nerves and thereby improving urinary frequency, urge incontinence, urinary retention, interstitial cystitis, irritable bowel syndrome and several other ailments.
Why is it Safe?
The gentle stimulation required to correct faulty sacral nerve communications is introduced in the tissues just under the skin over the sacrum (tailbone) through a small lead (wire). The lead is not actually touching the nerves and is not anywhere near the spine. The technology is similar to that of cardiac pacemakers and has been proven safe during the last 15 years of use on an international scale. Not a single patient has ever suffered a non-reversible health consequence as a result of Sacral Nerve Stimulation and the treatment is reversible should the patient decide not to continue with the therapy for any reason.
Stage One: Test Stimulation
Sacral Nerve Stimulation is unique in that a test is performed to assess the effectiveness of the therapy prior to placing a permanent implant. An outpatient procedure is performed in the operating room under local anesthetic with sedation.
Two small incisions are made in the skin. One incision is over the sacrum just to the side of the sacrum’s midline. A second incision is made in the upper buttock.
The lead is placed just under the skin through the incision over the sacrum. A temporary lead extension is placed just under the skin through the incision over the upper buttock. The temporary lead extension is plugged into a temporary stimulator that can be worn on the waistband either inside or outside of the clothing.
The temporary stimulator is used for two weeks to assess the results of the stimulation.
Pre- Test Instructions:
- A voiding diary is maintained for three days.
- No aspirin or other blood thinning medications should be taken for 7 days. Nothing to eat after midnight the night prior to the test date.
Post Test Instructions:
- Maintain voiding diary.
- Take antibiotics as prescribed.
- Take Tylenol or prescribed medication for pain if needed.
- Dressings over the two incisions may be removed the day after the procedure (tape strips under the dressings will remain in place).
- Showers may resume 24 hours after the procedure (no soaking). Unplug test box prior to showering.
- Limit lifting (nothing over 10 pounds for 30 days).
Use of the Temporary Stimulator:
The unit is small enough to be worn inside or outside of your clothing and is powered by an ordinary 9 volt battery. The device also has a clip that can be used to hold the unit on the waistband.
There is an on-off/power dial marked with the letter “A”. This dial is used to activate the unit and control the intensity of the stimulation. When the unit has been turned on using the” A” dial, a small green light next to the” A” dial flashes. The green flashing light indicates the unit is functioning normally.
Use the power dial to ensure you feel the stimulation prominently, but comfortably.
Stage Two: Remove Test Lead or Place the In-Dwelling Stimulator
After approximately 14 days, you will return to the hospital with your voiding diary. The pre and post-test diaries will be compared and your doctor will review the results with you and your family. If the test was a success, you may elect to have the implanted stimulator placed in the same incision created to place the temporary lead extension (it will not be necessary to disturb the incision that was made over the sacrum).
You will receive your patient programmer and instructions for using it to activate the stimulator as well as how to increase and decrease the intensity of the stimulation as you desire.
If the test was deemed a failure, or if you elect not to move forward with the implanted stimulator for any reason, the test lead will be removed.
- No eating after midnight the night before the procedure.
- No aspirin or blood thinning medications for one week prior to the procedure. Bring your “During Test” voiding diary with you.
Post Procedure Instructions:
- Dressing may be removed the next day.
- Tape Strips will remain until they fall off on their own.
- You may shower after 24 hours (no soaking).
- You may activate the stimulator with your programmer whenever you desire.
- Call the office for a follow up appointment to take place within 2-3 weeks to check the incision and adjust stimulator programming if necessary.
- Call the office if you develop any fevers or redness at the incisions.
- Limit lifting (nothing over 10 pounds for 30 days).
- Diathermy (for muscle relaxation) should not be used if nerve stimulator is present.
- Some theft detectors and screening devices may rarely cause the stimulator to turn on or off, or cause a harmless brief sensation as you approach the device.
- You will have an ill card to present at the airport or other security area in the event the device activates the security unit.
- Be certain to let your physicians know you have a pacemaker device and always shut the device off prior to undergoing any surgical procedure.
- MRI scans should not be performed.