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March 03, 2009

Urology Experts at Rush University Medical Center Use InterStim Therapy for Urinary Control

Thirty-three million Americans – from teenagers to older adults - suffer from bladder control problems that may cause them to struggle with everyday activities, and some patients have not found relief from medications, physical therapy or behavior techniques.

A small, surgically implanted device that works by electrically stimulating the sacral nerve may provide a solution for some patients who don’t respond to other treatments. Called InterStim Therapy, this approach treats the symptoms of overactive bladder, such as urge incontinence or urgency-frequency, according to Dr. Lev Elterman, urologist in the Program for Abdominal and Pelvic Health at Rush University Medical Center.

InterStim Therapy acts on the sacral nerve which influences the bladder and surrounding muscles that manage urinary function.  The electrical stimulation may eliminate or reduce certain bladder control symptoms.

“This is for patients who cannot have a normal life because of frequent trips to the bathroom.  It is the last resort for patients who have tried everything else, like medication and pelvic floor physical therapy, and have not had success,” said Elterman.

Jetta Beckman, a nineteen year old student, is the youngest patient to receive InterStim therapy. Starting in 2007, Beckman had constant symptoms of a urinary tract infection.  “I would experience burning, bleeding, cold sweats and pain in my back that made me feel like I had a kidney infection,” said Beckman.

Beckman was placed on multiple antibiotics and decided to come to Rush after her problems worsened.  Elterman recommended a trial of the InterStim Therapy System. 

Elterman explains, “InterStim is essentially a pacemaker for the bladder.  The electrode stimulates the nerve to the bladder with an electrical pulse.  That pulse interrupts the signal to the brain that was making the patient feel urgency and in turn it stops the bladder from squeezing.”

“Before I had the stimulator, I was going to the bathroom 18 to 20 times a day.  Now, I’m just going four,” said Beckman.  “It calms the bladder and helps it to relax.  And now I can definitely go out a lot more and do more things, like going to a movie.”

Treatment with InterStim therapy involves three steps: test stimulation, surgical implant and post-implant follow-up.  During the test stimulation, the patient wears an external stimulator that sends mild electrical pulses to the sacral nerve via a temporary lead, which is implanted under the skin in the upper buttock.  Following a successful trial, a tined or chronic lead is placed near the sacral nerve and connected to a neurostimulator.  After the implant, the neurostimulator is activated and controlled by the patient through a programmer that allows for adjustments in intensity of the stimulation.  Follow-up examinations usually occur every six to twelve months to monitor the therapy’s effectiveness.

The surgery is done on an outpatient basis and the InterStim therapy is a reversible treatment.  Physicians and patients can assess the effectiveness of the therapy through a test stimulation before implanting the entire system, which is reversible should the patient decide to discontinue with the therapy. 

Glen Nixon, 53, had the InterStim system implanted permanently in April 2008 and has experienced successful results.  “I was going to the bathroom 25 to 30 times a day and could barely leave the house.  I was in pain.  They put the temporary system in and from day one I knew this is what I wanted,” said Nixon.

About the Program for Abdominal and Pelvic Health at Rush
The Program for Abdominal and Pelvic Health) at Rush University Medical Center provides a multispecialty comprehensive approach to diagnosing and treating a wide range of abdominal and pelvic conditions in women and men of all ages. Led by Dr. Marc Brand, a colorectal surgeon, and Dr. Sheila Dugan,, a physiatrist, the clinical team at the includes colorectal surgeons, gastroenterologists, gynecologists and urogynecologists, physiatrists (rehabilitative and physical medicine specialists), physical therapists, psychologists, radiologists, and urologists.

About Urology at Rush University Medical Center
The Department of Urology at Rush provides comprehensive care for urological diseases. Physicians in the program are experienced in the latest techniques in the field, including laparoscopic surgery and other minimally invasive techniques that enable patients to return to normal activity much more quickly than with traditional therapies.

In U.S. News & World Report’s 2008 issue showcasing "America's Best Hospitals," the Department of Urology at Rush ranked #24 in the country. Rush ranked in seven of 16 categories in 2008.


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