What is InterStim Therapy?
InterStim therapy is a treatment that
may relieve urinary and bowel control symptoms. InterStim therapy
involves surgically implanting a small neurostimulator device and a
lead, which delivers gentle stimulation to the sacral nerve, much like a
pacemaker does for your heart. The stimulation may reduce your
symptoms to a tolerable level, enabling you to resume many of your
Bladder control problems are often caused by interruptions in the
communication between the brain and the bladder. The InterStim
system can “jump start” the signals traveling along the nerves to your
bladder, and help restore more normal bladder function.
Is InterStim right for me? Many women experience symptoms of
over active bladder (OAB), urinary frequency and urgency, urge
incontinence or urinary retention. Your doctor may recommend
InterStim therapy if medication, biofeedback therapy, pelvic floor
physical therapy or behavior modification have not provided enough
benefit for you.
Step 1: Basic Evaluation: A basic evaluation is a
minimally invasive procedure, performed in the
office, under local anesthesia. Two temporary
leads (special wires) are placed through a pinpoint
opening in your sacrum. After the leads are
positioned and secured, stimulation is delivered to
your sacral nerve as you go about your normal
activities. You will return to the office one week
later for removal of the leads. If your urinary
symptoms improve significantly with stimulation,
you may proceed to InterStim implant (Step 3).
Step 2: If the results of the basic evaluation are inconclusive your
doctor may recommend another test called an Advanced Evaluation,
involving one or two outpatient surgeries performed under light
sedation about two weeks apart. A chronic lead will be implanted near
your tailbone during the procedure. During the trial period, an
InterStim nurse or technician will instruct you to test different settings
on the lead using a control box. If the test is successful, you will
proceed to step 3. If there was not marked improvement in symptoms
during the trial the lead will be removed.
Step 3: If your trial phase was the basic evaluation, you will have the
permanent lead implanted in the sacrum, which will be connected to a
small pulse generator implanted in your buttock. If you underwent the
advanced evaluation and had improvement in your urinary symptoms,
you will have the pulse generator connected to the existing lead.
After InterStim implant you will have follow up appointments with
your doctor to make sure the device is programmed in the best way to
control your symptoms. You will receive a remote control device to
control stimulation, and you may see the InterStim nurse or technician
as needed to adjust settings for optimal benefit. This may take a few
visits after the initial implant. Once the most appropriate settings are
determined, you will need to be followed annually or as needed.
Patients can expect up to 5 years of benefit before the device may
need to be replaced due to battery depletion.