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SOLUTIONS FOR
BLADDER CONTROL
AND BOWEL CONTROL
Bladder and Bowel control problems are treatable conditions and symptoms are manageable. Contrary to preconceptions neither of these pathologies is a normal part of aging or a consequence of giving birth. It is a medical condition for which it is important to seek medical advice.
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Learn more about the types of urinary incontinence
Stress urinary incontinence (SUI)*
Characterised by 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.
*InterStim™ is not indicated for treatment of this condition
Overactive Bladder (OAB)
Characterised by an increased pressure or abnormal contractions of the bladder.
OAB consists of several symptoms and is defined by a sudden and irrepressible need to void which can't be postponed.
Sometimes the frequency of the voids increases and there is a need to go to the bathroom 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 SUI and OAB described above can co-exist. In this case, it is called mixed incontinence.
Your bladder control matters
OAB is extremely common and disrupts the lives of more than 17% of people in Europe4. Urinary incontinence causes distress and alters quality of life. It is not just women that suffer.
65% of men and 67% of women with an overactive bladder4 reported that their symptoms influenced their daily life. This condition can make simple everyday activities a challenge and social life very difficult.
SOLUTIONS EXIST
Even if the journey can be long, solutions are available, and each patient may be offered suitable therapies according to his/her symptoms. Solutions are available.
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 retaining, pelvic floor exercises/physical therapy
- Medication
If these treatments are not working or not well tolerated, other specialised options can be offered such as Sacral Neuromodulation or Botulinum Toxin:
- Botulinum toxin injection: Injecting botulinum toxin into the bladder wall may relieve the sense of urgency by preventing the nerves that control the bladder from communicating to the bladder muscles. Repeat injections are necessary
- 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
WHAT IS FECAL INCONTINENCE
Fecal incontinence, prevents you from controlling your bowel movements. You may experience unexpected leaks, or use the bathroom very frequently. Some people experience a combination of these symptoms.
With fecal incontinence you may experience:
- Have diarrhoea
- Feel the urgent need to go to the toilet and/or not reach the toilet on time
- Have constipation
- Stain or soil your underwear
YOUR BOWEL CONTROL MATTERS
Fecal incontinence is more common than you think and affects 4.8-6.7% of adults.3
It is possible you can suffer from both bladder and bowel problems.5
17% of adults suffer from OAB in Europe.4 18%of patients with OAB may also have fecal incontinence6.
Even if the journey can be long, solutions are available, and each patient may be offered suitable therapies according to his/her 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 treatments: lifestyle changes, fluid and diet modifications, bowel retraining, pelvic floor exercises/physical therapy
- Medication: Your doctor may prescribe medications to help control the symptoms
If these treatments are not working or not well tolerated, other specialised options can be offered.
SACRAL NEUROMODULATION
Sacral neuromodulation is a well-established therapy with long-term positive outcomes shown in clinical studies and is a recommended therapy in international clinical guidelines. More than 325,000 patients worldwide, over the course of the last 25 years7, have received the InterStim™ System for bladder control and bowel control.
Sacral Neuromodulation with the InterStim™ System uses a small implanted medical device to send mild electrical pulses to nerves that control your bladder and bowel. It helps to restore normal nerve activity so that you can urinate and defecate normally8,9.
Getting InterStim™ Therapy
InterStim™ Therapy is performed in 2 phases:
- Evaluation phase
- Implant phase
The evaluation is a temporary phase used to measure the effectiveness of the InterStim™ Therapy in your daily life. It is the only tool which can give an indication of the long-term outcome of the therapy.
Patients who experience relief from their symptoms during the evaluation phase may be candidates for a permanent implant like more than 325,000 patients worldwide.
If the evaluation phase was successful, your doctor may propose to 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 bowel
- 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
- Only in case of a rechargeable system, a portable recharger that enables you to recharge the neurostimulator
LIve WITHOUT LIMITS
With the InterStim™ systems, get back to living your way
Choose the InterStim™ system that’s right for you
Medtronic lets you and your doctor choose between the convenience of a recharge-free device and the long-lasting performance of a rechargeable system.
Both systems are full-body* MRI eligible and deliver the same therapy with the long-term results10,11 you want.
Indications:
Sacral neuromodulation therapy provided by the InterStim™ system is indicated for the management of the following chronic intractable (functional) disorders of the pelvis and lower urinary or intestinal tract: overactive bladder, fecal incontinence, and non-obstructive urinary retention.
Contraindications:
Diathermy. Patients who have not demonstrated an appropriate response to test stimulation or are unable to operate the neurostimulator.
Information contained herein does not replace the recommendations of your healthcare professional.
See the device manual for detailed information regarding the instructions for use, the implant procedure, indications, contraindications, warnings, precautions, and potential adverse events. For further information, contact your health care professional.
Safety and effectiveness have not been established for:
- Paediatric use
- Pregnancy
- Uncorrected high-grade internal prolapse
1
Hunskaar S, Lose G, Sykes D, Voss S. The prevalence of urinary incontinence in women in four European countries. BJU Int. 2004 Feb;93(3):324-330.
2
Eurostat EU28 data: https://ec.europa.eu/eurostat/data/database
3
Giebel et al. Prevalence of fecal incontinence: what can be expected? Int J Colorect Dis (1998) 13: 73–77
4
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.
5
Soligo M, et al. Double Incontinence in Urogynecologic practice: A new insight; AM J Obstet Gynecol 189: 438 443 (2003).
6
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.
7
Medtronic data on file.
8
Wendy W. Leng et al. How Sacral Nerve Stimulation Neuromodulation Works. Urologic Clinics of North Americad doi: 10.1016/j.ucl.2004.09.004
9
Gourcerol G. et al. How sacral nerve stimulation works in patients with faecal incontinence. Colorectal Dis. 13(8):e203-11 (2011)
10
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.
11
Hull et al. Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence Dis Colon Rectum 2013; 56: 234–245 DOI: 10.1097/DCR.0b013e318276b24c