Neuromodulation of the bladder
Neuromodulation therapy involves the implanting of a device to treat urinary issues. It helps to reset the signal to the bladder to help improve urinary symptoms. Severe overactive bladder (OAB), is a common condition that occurs when an individual experiences sudden intense urges to urinate, frequent urination, or urinary incontinence. These symptoms occur because the bladder muscles that control the release of urine contract at inappropriate times and cause intense symptoms. Medical conditions may also lead to urinary retention.Neuromodulation therapy stimulates the affected nerves with electrical impulses in order to overcome bladder issues. It is used when other methods of bladder control have been ineffective or side effects of treatments are bothersome.
Candidates for Neuromodulation Therapy
Neuromodulation therapy is recommended for patients who have not had adequate response, or side effectsfrom medications for OAB. A patient would generally need to have failed or has contraindications to multiple medications and has completed bladder function studies such as urodynamics and cystoscopy to rule out other causes for their symptoms. Patient that are seeking relief from the symptoms associated with the condition, such as:
● Moderate to severe urinary urgency
● Urinary frequency
● Urge urinary incontinence
● Nocturia, urges to urinate that interrupt sleep frequently
● Retention of urine
Benefits of Neuromodulation Therapy
Neuromodulation therapy has a number of advantages over other treatments for bladder disorders, including:
● Pretesting phase to determine potential for success
● High rate of efficacy (approximately 80 percent have improvement in symptoms)
● Minimally invasive, short, safe procedure under sedation
● Immediate improvement following implantation
● Device is MRI compatible
● Easy to use and adjust
● It is removable
The Neuromodulation Implantation Procedure
A device is implanted near the tailbone to help facilitate proper signal transmission between the brain and the sacral nerves. The sacral nerves are the same nerves that send signal to the bladder and surrounding muscles. This therapy uses a device about the size of a USB flashdrive, which is inserted under the skin. The neuromodulator sends electrical signals to the sacral nerves. offering relief to patients with bladder issues such as frequency, urgency and incontinence.Once the patient and provider decide on this method of treatment, the device is implanted as test phase to ensure that it is effective for symptoms. If the trial is successful, the permanent device is implanted low in the patient's back. The procedure, which takes about an hour to complete, is performed with the patient under sedation and comfortable.
Complications of Neuromodulation Therapy
Although the procedure is considered safe and effective for treatment, as with all medical procedures, there is a risk of complications. While relatively rare, some patients may experience temporary side effects at the implantation site including:
● Pain
● Irritation
● Infection
● Bruising