The Interstim sacral neuromodulation device is an advanced treatment for overactive bladder.
Interstim uses a small implantable electrode to stimulate the sacral nerves in the tailbone and restore normal communication between the nervous system and bladder. After placement of the electrode with a numbing injection in the skin, an initial one-week test phase is conducted with the wire attached to an external battery pack to ensure a good therapeutic result. If there is insufficient response, the electrode is simply removed. If there has been more than a 50% improvement in symptoms, a small implantable battery is placed underneath the skin during a follow-up procedure.
When to ask a Urologist about Interstim
You should speak with a Urologist about Interstim if you are still bothered by overactive bladder symptoms despite oral medications.
Typically covered by most insurances (although coinsurance and deductibles may apply). Coverage will be verified prior to proceeding. If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.
Interstim yields a greater than 50% urinary symptom improvement in almost 90% of patients. In general, patients experience about 50% greater symptom improvement than with oral medications alone. The Interstim device battery must be replaced about every 3-5 years and precludes MRI scans below the neck.
Possible Side Effects
Possible risks following Interstim include persistent or recurrent urinary symptoms, discomfort over the tailbone area, bleeding, infection, and the need for surgical revision.
Other options for the management of overactive bladder include observation without treatment, lifestyle modifications, oral medications, percutaneous tibial nerve stimulation (Urgent PC), or bladder Botox injections.
What to do to Prepare for Surgery
You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery (when to stop depends on the type of blood thinner). Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.
On the day before surgery, you will receive a phone call alerting you to the time that you should arrive, and you should wash the surgical area with an antibacterial soap.
You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.
What to Expect after Surgery
This surgery is performed in an outpatient setting with light sedation so patients return home after the procedure. Before returning home, you and your family members will meet with an Interstim device representative to review device programming and your handheld control for the device. The device manufacturer Medtronic has a telephone helpline available to troubleshoot difficulty operating the handheld control if there are problems after you have returned home.