Getting Medtronic bowel control therapy
#WorldContinenceWeek
Medtronic Bowel Control Therapy (Sacral Neuromodulation) is designed to minimize the symptoms of chronic bowel incontinence, including the leakage of liquid or solid stools. Sacral neuromodulation may be a good option for people who have not had success with, or are not candidates for, more conservative treatments.
Is it right for you? Test it first
The evaluation, also known as the "trial assessment," lets you try Medtronic Bowel Control Therapy to see if it is right for you without making a long-term commitment. The evaluation may take a few to several days to complete.
How the evaluation works
Here’s how it works:
- Your doctor will implant a thin, flexible wire (also known as a "lead," and pronounced "leed") near your tailbone. The wire is taped to your skin and connected to a small external device which you’ll wear on your waistband.
- The external device sends mild electrical pulses through the wire to nerves near your tailbone. The stimulation may get your bowel working the way it is supposed to.
During the evaluation, you can continue many of your low- to moderate-level daily activities with caution. You can usually continue to work throughout the evaluation period if your job doesn’t require strenuous movement.
Complications can occur with the evaluation, including movement of the wire, technical problems with the device, and some temporary pain.
You’ll be asked to document your symptoms. The evaluation will help your doctor determine the next course of treatment for your bowel control problems.
Your doctor or nurse will give you information about operating the test stimulator. He or she will also tell you about any precautions or activity restrictions related to the evaluation.
The results of Medtronic Bowel Control Therapy vary from person to person. This treatment option is not a cure for bowel control problems; however, it may help relieve your symptoms.
Your healthcare team
As you begin the journey to diagnose and treat bowel incontinence, you may meet a variety of medical professionals dedicated to giving you their best possible care. It’s important to be open and up-front with your health-care providers about your symptoms, lifestyle, and treatment concerns.
Gastroenterologist
Gastroenterologists specialize in diseases of the gastrointestinal tract, which includes the esophagus, stomach, colon and rectum, pancreas, gallbladder, bile ducts, and liver. These experts are often responsible for research involving gastrointestinal procedures and interpreting research results.
Colorectal surgeon
Colorectal surgeons are experts in both surgical and non-surgical treatment of colon, rectum, anus, and small bowel problems. They treat benign and malignant conditions, conduct routine screening examinations, and perform surgery when necessary.
Gynecologist
Gynecologists specialize in women's general health, including care of reproductive organs, breasts, sexual function, and hormonal disorders. Gynecologists also treat pelvic organ and pelvic floor problems.
Urogynecologist
Urogynecologists specialize in diseases of the female urinary tract and pelvic reconstructive surgery. They also treat bowel problems, including bowel incontinence.
Urologist
Urologists are surgeons who specialize in diseases of the male and female urinary tract and the male reproductive organs. Some urologists have specific experience in the treatment of incontinence.
Nurse, nurse practitioner, or physician assistant
A nurse, nurse practitioner, or physician assistant typically works closely with your doctor. He or she may answer questions, and advise you on treatments such as Kegel exercises, diet modification, or physical therapy.
Physical therapist
Your doctor may prescribe physical therapy to strengthen the muscles in your pelvic floor. Pelvic floor rehabilitation may include pelvic floor stimulation and biofeedback-guided pelvic floor exercises, used alone or in combination.
Insurance coverage/Cost
Coverage will be determined on a case-by-case basis. Your physician will submit a coverage request to your insurance company on your behalf prior to the evaluation to determine if you are eligible for coverage.
Approval process
Typically, your doctor will work with you to get prior approval from your insurance company. He or she will send a letter of medical necessity explaining why Medtronic Bowel Control Therapy is right for you and confirming that more conservative treatments have been unsuccessful.
Sometimes insurance companies are unfamiliar with Medtronic Bowel Control Therapy (Sacral Neuromodulation) and may turn down your initial request. Don’t be alarmed if this happens to you. Often, sending more information as part of an appeal can be helpful.
Questions and answers
Find answers to commonly asked questions about Medtronic bowel control therapy and the Neuromodulation System.
No. The evaluation is temporary. The evaluation helps your doctor determine the next course of treatment for your bowel control problems. Once the wire is removed, your original symptoms will return.
Sacral neuromodulation varies from person to person, but most people describe it as a slight pulling or tingling sensation in the pelvic area. It should not be painful. Stimulation can also be set to sub-sensory levels at which point it is no longer felt.1 Talk to your doctor if you have any concerns.
Complications can occur during the evaluation including movement of the wire, technical problems with the device, and some temporary pain.
In some cases, these issues can be resolved during the evaluation, so be sure to talk to your doctor about your experience.
If you had good results during the evaluation, you and your doctor may choose to use the System for long-term treatment of your symptoms.
If your evaluation results using the temporary lead are inconclusive, your doctor may recommend a second evaluation using a long-term lead or recommend a different treatment option.
Be sure to discuss the potential risks and benefits of the therapy with your doctor.
Implanting a Neuromodulation System has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection. Talk with your doctor about ways to minimize these risks.
The System might cause you to experience some of these side effects:
- Pain at the implant site or new pain
- Infection or skin irritation
- Lead (thin wire) movement/migration
- Device problems
- Interactions with certain other devices or diagnostic equipment such as MRI
- Undesirable changes in urinary or bowel function
- Uncomfortable stimulation (sometimes described as a jolting or shocking feeling)
Problems may be resolved with surgery, medical therapy such as drugs, or reprogramming. These events may also resolve over time. There is a possibility that some may remain unresolved.
Typically, your doctor will work with you to get prior approval from your insurance company. He or she will send a letter of medical necessity explaining why the Neuromodulation System is right for you.
Implanting a Neuromodulation System has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection. Talk with your doctor about ways to minimize these risks.
The System might cause you to experience some of these side effects:
- Pain at the implant site or new pain
- Infection or skin irritation
- Lead (thin wire) movement/migration
- Device problems
- Interactions with certain other devices or diagnostic equipment such as MRI
- Undesirable changes in urinary or bowel function
- Uncomfortable stimulation (sometimes described as a jolting or shocking feeling)
Problems may be resolved with surgery, medical therapy such as drugs, or reprogramming. These events may also resolve over time. There is a possibility that some may remain unresolved.
Duelund-Jakobsen, Jakob MD; Buntzen, Steen MD, DMSc; Lundby, Lilli MD, PhD; Laurberg, Søren MD, DMSc. Sacral Nerve Stimulation at Subsensory Threshold Does Not Compromise Treatment Efficacy: Results From a Randomized, Blinded Crossover Study. Annals of Surgery 257(2):p 219-223, February 2013. | DOI: 10.1097/SLA.0b013e318269d493