HOUSTON - Have you ever been held hostage by your own bathroom? That's the reality for the more than 200 million people suffering from overactive bladder worldwide. Now, a solution springs from the same technology doctors use to keep ailing hearts ticking.
Soda pop used to be a nightmare for Sue Nelson.
"You have to constantly be close to a bathroom," said Nelson.
Nelson was one of the 25 million Americans living with bladder control issues. Eighty percent are women. Her bladder was telling her it was full even though it wasn't. She couldn't leave the house.
"People get embarrassed because it's not something you sit down and talk about over dinner," explained Nelson.
"It's almost like the bladder reverts back to a child-like bladder," said Christopher Smith, M.D., from Baylor College of Medicine in Houston.
Dr. Smith reaches for a device to help his patients. It's a pacemaker, of sorts, that's implanted into Nelson's lower back. It weighs just an ounce. Electric stimulation sent to the base of the spine tells patients when their bladder is truly full.
"It filters these signals, these overactive signals, between a patient's bladder and their brain," explained Dr. Smith.
Studies show 56 percent of users cut their bathroom trips in half, and 46 percent of patients had zero bladder control issues.
"It's like, back to my old life," said Nelson.
While Nelson was never keen on talking about her problem, she'll happily tout the solution.
"This is just something that happens to some people, and there is hope," she said. "There is hope."
Experts said up to 75 percent of people suffering from overactive bladder don't respond to medication. People who want this device can wear an external version for seven days before committing to full surgery.
RESEARCH SUMMARY:
BACKGROUND: Millions of people experience bladder control problems, including urinary urge incontinence, non-obstructive urinary retention, and significant symptoms of urgency-frequency. An innovative therapy for overactive bladder and urinary retention called sacral nerve stimulation (InterStim Therapy) is available for patients who have failed or could not tolerate more conservative treatments. The therapy provides urinary control therapy that addresses the nerve component of bladder control problems. Over 75,000 patients have received sacral nerve stimulation worldwide. The therapy is minimally invasive and begins with a simple in-office test. Sacral nerve stimulation is indicated for patients who suffer from urinary urge incontinence, urinary urgency-frequency, or non-obstructive urinary retention. (SOURCE: MedTronic)
PROCEDURE: Sacral nerve stimulation is conducted through an implanted device that includes a thin insulated wire called a lead and a neurostimulator (much like a cardiac pacemaker.) The device is inserted in a pocket in the patient's lower abdomen. It sends mild electrical impulses through a lead that is positioned close to a nerve located in the lower back (the sacral nerve), which influences the bladder, the sphincter and the pelvic floor muscles. Sacral nerve stimulation is first tried on an outpatient basis in the doctor's office with the implantation of a test lead. If the trial treatment is successful, the patient is scheduled for inpatient surgery. Permanent surgical implantation is done under general anesthesia and requires a one-night stay in the hospital. After the patient has been anesthetized, the surgeon implants the neurostimulator, which is about the size of a pocket stopwatch, under the skin of the patient's abdomen. Thin wires, or leads, running from the stimulator carry electrical pulses from the stimulator to the sacral nerves located in the lower back.
MAINTENANCE: The battery inside the neurostimulator typically needs to be replaced every 3 to 5 years. The battery life will fluctuate per individual, depending on the strength of the signal needed to control symptoms and the amount of use each day. When it is time for the battery to be replaced, the entire neurostimulator will be replaced with a new one.
WHAT'S NEXT: Initially used to treat urinary symptoms, sacral nerve stimulation has recently also been used to treat fecal incontinence and constipation. The technique has been refined, by introducing a minimally invasive two stage implantation, so that patients can undergo a prolonged test stimulation using a permanent lead. Accurate neurophysiological evaluation can now be performed before, during, and after implantation and this has confirmed improved treatment success rates.
FOR MORE INFORMATION, CONTACT:
Christopher Smith, MD
Baylor College Of Medicine – Houston
cps@bcm.edu
