Urinary Incontinence

Description

Alternative Names

Other Procedures

The sacral nerves are located in the tail bone and appear to play an important role in regulating bladder control. Therapies have been devised that stimulate these nerves to help control the bladder in patients with urge incontinence. The sacral nerve stimulation system (InterStim) sends electrical pulses to the sacral nerves to help retrain them. InterStim is reserved for the treatment of urinary retention and the symptoms of overactive bladder in patients who have failed or could not tolerate less invasive treatments.

• The procedure employs a stopwatch-size device that is implanted under the skin in the abdomen.
• A wire connected to it runs to the sacral nerves in the lower back.
• The device is actually a battery-operated generator and produces the electrical pulses that are sent to these nerves.
• The electrical pulses help offset the hyperactivity of the bladder.
• The sensation of the electrical pulse is similar to a slight pulling sensation in the pelvic area. Some times it can cause a small jolt or shock if the patient changes posture quickly. It should not cause pain. (If it does, then something is wrong with the device.)

Complications include infection, lower back pain, and pain at the implant site. It is completely reversible, however, does not cause nerve damage, and can be removed at any time.

Patients have reported improvement in the number of urinations, the volume of urine per void, the intensity of urgency, and in their quality of life. Studies report complete dryness in nearly half of patients, with about 75% of patients experiencing relief from heavy leaking.

Transcutaneous Neuromodulation. The use of electrodes on the surface of the skin, called transcutaneous neuromodulation, may prove to be beneficial and particularly attractive for children.

Percutaneous Stoller Afferent Nerve Stimulation. The percutaneous stoller afferent nerve system (PerQ SANS System) has also been approved for urge incontinence.

• In this therapy, a very thin needle is inserted a short distance above the ankle bone.
• The needle is applied to the tibial nerve in the ankle, which connects with the sacral nerve complex.
• Low-frequency electrical stimulation is applied for 30 minutes once a week for about three months.
• After that, depending on the patient's response, treatments are given every week to every other week.
• Short-term results are promising, but more research is needed.

Repair of Prolapsed Uterus or Vagina

Procedures that repair a prolapsed (fallen) uterus or vagina can often correct incontinence in women who have these conditions.