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BLADDER ACCIDENTS OR LEAKAGES
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Bladder control problems can be embarrassing. You may leak small or large volumes of urine, use the bathroom very frequently, or not be able to completely empty your bladder.
What is urinary incontinence?
Urinary incontinence is any involuntary or unwanted loss of urine. People use the bathroom very frequently and may leak urine. There are different types:
Stress urinary incontinence (SUI)*
Is an involuntary loss of urine during effort: lifting heavy things, laughing, coughing, sneezing or doing exercise.
During these kind of activities, the pressure on the bladder increases and the urethra or urinary sphincter can’t resist the pressure and will leak urine.
Urinary retention
You may:
Spend a long time at the toilet but produce only a weak, dribbling stream of urine.
- Leak urine (also called overflow incontinence)
- Not have a sensation when your bladder is full
- Have to use a catheter to empty your bladder
OVERACTIVE BLADDER (OAB)
Is an increased pressure or abnormal contractions of the bladder. Overactive bladder consists of several symptoms and is defined by a sudden and uncontrollable need to urinate which can’t be postponed.
Sometimes, the frequency of the need to pass urine increases and going to the toilet becomes more often during the day or night. Bladder leakages may also occur. In most cases, there is no cause found, so, we talk about idiopathic overactive bladder. The different symptoms of stress urinary incontinence and overactive bladder described above.
You can suffer from both bladder and bowel problems.2
overactive bladder (OAB)
FAECAL INCONTINENCE
Alison's Story
“My life opened up again.” Those are Alison’s words as to how InterStimTM II helped her to take back control.
QUALITY OF LIFE
65% of men and 67% of women with an overactive bladder1 reported that their symptoms influenced their daily life. This condition can make simple everyday activities a challenge and social life very difficult.1
Having bladder incontinence can cause other problems and can include:
PHYSICAL
38% were less physically active, 34% gained weight because they were unable to exercise.4
PSYCHOLOGICAL
Overactive bladder also negatively affects self-esteem and can be associated with anxiety and depression.5
OCCUPATIONAL
Absence from work, decrease in productivity.6
SOCIAL
Reduction in social interaction, limited and planning travel around toilet accessibility.6
PHYSICAL
Requirements for specialised underwear, bedding, special precautions with clothing.6
SOLUTIONS EXIST
Even if the journey can be long, solutions are available, and you should be offered suitable therapies according to symptoms.
If there is an underlying cause to the symptoms, this should be treated first. First line treatments should be proposed by your doctor:
- Behavioural techniques: lifestyle changes, fluid and diet modifications, bladder retraining, pelvic floor exercises/physical therapy
- Medication: your doctor may prescribe medications to help control the symptoms of overactive bladder
If these treatments are not working or not well tolerated, other specialised options can be offered.
It’s time for another option.
sacral neuromodulation:
Sacral neuromodulation therapy with the InterStim™ system can help to restore normal bladder function. This therapy addresses the communication problem between the bladder and the brain that may be causing your symptoms.
HOW SACRAL NEUROMODULATION WORKS
Medtronic bladder control therapy works with the sacral nerves, located near the tailbone.
The sacral nerves control the bladder and muscles related to urinary function.
If the brain and sacral nerves are miscommunicating, the nerves can’t tell the bladder to function properly.
Sacral neuromodulation helps the brain and the nerves to communicate so the bladder and related muscles can function properly.7
It may help you resume normal activities and help you avoid frustrating or embarrassing experiences associated with overactive bladder.
PATIENT JOURNEY
Sacral neuromodulation with InterStim™ system: an adjustable, reversible and lasting results therapy
01. Start with a test
With Medtronic bladder control therapy’s two-step process, you can test it out to see if it will work for you before making a long-term commitment. The testing period is called an “evaluation“. The evaluation is temporary and generally lasts around 1-2 weeks. It is used to measure the effectiveness of the InterStim™ therapy in your daily life.
- The test is started in a hospital setting and your consultant and/or nurse will tell you about the evaluation procedure. They will discuss the options for using either a temporary lead (a thin wire) or a long-term lead for the evaluation
- Before and during the evaluation, you’ll be asked to track your symptoms to help determine how well Medtronic bladder control therapy works for you
02. TOGETHER, DECIDE WHAT’S BEST FOR YOU
- If you experienced relief from your symptoms during the evaluation phase, you may be offered a permanent implant
- Together, you and your doctor will decide if the long-term therapy is the right choice. If it is, your evaluation device can be replaced with an implantable device called a neurostimulator
03. implant phase
If the evaluation phase was successful, your consultant may propose you the implant of an InterStim™ system. The InterStim™ system consists of:
- An implantable neurostimulator which is like a pacemaker implanted under the skin
- A lead which is a thin wire that carries mild electrical pulses to the nerves controlling the bladder
- A hand-held patient programmer that enables you to adjust the level of the stimulation and allows you to turn your neurostimulator on or off
04. life after therapy
Sacral neuromodulation therapy may allow you to resume many daily activities.
- Minimal follow up required - once per year recommended
- There is now recharge-free and rechargeable option available and your consultant will help you decide which option is best for you based on your needs
- InterStim™ SureScan™ and InterStim™ SureScan™ Micro™ are approved for MRI under specific conditions9^
CHOOSE A THERAPY WITH LONG-LASTING RESULTS
- Sacral neuromodulation is a well-established therapy
- 300,000 patients worldwide have received the InterStim™ system for bladder and bowel control
- The InterStim™ system has been available for over 25 years, treating on average 50 patients every day, for different indications worldwide†
91%
would recommend
to a friend in need10
82%
patients achieved success at 5 years11***
84%
had improved or greatly improved urinary symptoms11
The Management of Urinary Incontinence
If you are suffering from bladder incontinence, there are many treatment options available to you. Your healthcare professional will advise on what these are based on national guidelines.
The National Institute for Health and Care Excellence (NICE) guidelines for the management of urinary incontinence sets out the treatments available12. These are set out in a sequence, known as a care pathway, and these are the options available to you. During the course of your treatment, your healthcare professional will be guided by these guidelines.
You will need to try, in sequence, the various treatments recommended by your healthcare professional who should follow the guidelines. Below is an overview of the care pathway (treatments that are available) for bladder incontinence:
Diagnosis
“What is happening to me?”
Meet with a urinary incontinence specialist to see if you have OAB.
LIFESTYLE
CHANGES
“What should I try first?”
Conservative treatments can help some people, but may not work well for others.
- Diet and exercise
- Pelvic floor strengthening
- Bladder training
ORAL
MEDICATIONS
“Are there medication for overactive bowels?”
Oral medications can help, but may cause side effects.
ADVANCED
THERAPIES
“What if oral medications don't work?”
INJECTED MEDICATION
Injections into the bladder repeated every 3-6 months.
- Potentially requires self-catheterisations15
- Increases the risk of bladder infection due to self-catheterisation15
NEUROMODULATION
Therapies that use gentle nerve stimulation thought to normalise bladder-brain communication.13
Medtronic Bladder Control Therapy delivered by the InterStimTM system
- Try it during an evaluation
- Established long-term relief14
Implanting an InterStim™ system has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection. Talk with your doctor about ways to minimise these risks.
DOWNLOAD THE BLADDER CONTROL BROCHURE
That InterStimTM evaluation will indicate in only a few days if the InterstimTM therapy is effective for you?
DOWNLOAD HEREBLADDER HEALTH UK
For more information on bladder incontinence,
visit www.bladderhealthuk.org
^ Under certain conditions; see approved labeling for details.
* InterStim™ is not indicated for treatment of this condition.
** Battery longevity depends on therapy settings. Specific example was obtained in the treatment of fecal incontinence.
*** Therapeutic success was defined as a urinary urge incontinence or urgency-frequency response of 50% or greater improvement in average leaks or voids per day, or return to normal voiding, defined as fewer than 8 voids per day.
† Medtronic data on file.
1. Milsom, et al. “How widespread are the symptoms of an overactive bladder and how are they managed?“ A population-based prevalence study BJU Int. 2001 Jun; 87(9):760-6.
2. Soligo M, et al. Double Incontinence in Urogynecologic practice: A new insight; AM J Obstet Gynecol 189: 438 – 443 (2003).
3. Markland AD et al. Associated factors and the impact of fecal incontinence in women with urge urinary incontinence: from the Urinary Incontinence Treatment Network’s Behavior Enhances Drug Reduction of Incontinence study. Am J Obstet Gynecol. 2009 Apr;200(4):424.e1-8. doi: 10.1016/j.ajog.2008.11.023. Epub 2009 Feb 6
4. Dmochowski RR, Newman DK. Impact of overactive bladder on women in the United States: results of a national survey. Curr Med Res Opin. 2007;23:65-76.
5. Milsom, et al. -Effect of Bothersome Overactive Bladder Symptoms on Health-related Quality Of life, Anxiety, Depression, and Treatment Seeking in the United States :Results From EpiLUTS. Urology.-2012; 80 : 90-96.
6. A.Tubaro, -Defining Overactive Bladder: Epidemiology and burden of disease. -Urology. -2004; 64 (Supp 6A) : 2-6.
7. Wendy W.Leng.et.al. How Sacral Nerve Stimulation Neuromodulation Works.Urologic Clinics of North Americadoi:10.1016/j.ucl.2004.09.004
8. Widmann B et al. Success and Complication Rates After Sacral Neuromodulation for Fecal Incontinence and Constipation: A Single-center Follow-up Study. J Neurogastroenterol Motil. 2019 Jan 31;25(1):159-170.
9. Siegel, S., Noblett, K., Mangel J, et al. “ Five Year Follow-up Results of a Prospective, Multicenter Study in Overactive Bladder Subjects Treated with Sacral Neuromodulation.”
J Urol.2018;199(1), 229 – 236.
10. Leong R.K et al Satisfaction and Patient Experience with Sacral Neuromodulation: Results of a Single Center Sample Survey; Journal of Urology. 2011; vol. 185, 588-592
11. Steven Siegel et al. Five year follow up Results of a prospective, Multicentre Study of Patients with Overactive Bladder treated with Sacral Neuromodulation. Journal of Urology Vol, 199,229-236, january 2018. https://doi.org/10.1016/j.juro.2017.07.010.
See the device manual for detailed information regarding the instructions for use, implant procedure, indications, contraindications, warnings, precautions, and potential adverse events. See the MRI SureScan® technical manual before performing an MRI. For further information, contact your local Medtronic representative or consult the Medtronic website at www.medtronic.com.
Consult instructions for use at this website. Manuals can be viewed using a current version of any major Internet browser. For best results, use Adobe Acrobat Reader® with the browser.
12. Urinary Incontinence in Women: The Management of Urinary Incontinence in Women, National Collaborating Centre for Women’s and Children’s Health, Commissioned by the National Institute for Health and Care Excellence, September 2013
13. Leng, W. W. & Chancellor, M. B. How sacral nerve stimulation neuromodulation works. Urol. Clin. North Am. 32, 11–8 (2005).
14. Siegel, S. et al. Five-Year Follow up Results of a Prospective, Multicenter Study of Patients with Overactive Bladder Treated with Sacral Neuromodulation. J. Urol. 199, 229–236(2018)
15. Denys P et al. Efficacy and safety of low doses of xxxxxxxxxx for the treatment of refractory idiopathic overactive bladder: a multicentre, double-blind, randomised, placebo-controlled dose-ranging study. Eur Urol. 61(3):520-9 (2012)