There are over 25 million Americans living with bladder incontinence. The InterStim implant is manufactured by Medtronic for patients with urinary incontinence, which is the result of a disconnect between the brain and the bladder. It provides a type of sacral neuromodulation, or sacral stimulation, therapy to help patients get that connection back.
InterStim Stage 1
Stage 1 of InterStim therapy allows for a trial period evaluation. The patient will have a wearable, external version of the InterStim device for two weeks to see how he/she responds and if the treatment will be an effective path for the patient.
The InterStim implant will be put under the buttock area skin and connected to a wire that comes out of the skin. There will be a battery that is worn on the belt. Both of these in tandem allow sacrum nerves to be stimulated and can be altered to stimulate, or quiet, the bladder. After this stage is complete, patients will have a follow-up to see if this has improved symptoms. If improvement is shown, a physician may recommend moving toward stage 2 of the procedure.
Stage 1 limitations typically include limited physical activity, no sexual activity, no heavy housework or twisting, no bending of the waist, no heavy lifting, no hard exercise, and no “sliding” of the body across beds, couches, etc. At-home care recommends keeping the dressing dry and in place, and not using the shower or bathtub. Patients are otherwise encouraged to continue their normal routine with regard to any medications taken and their existing diet.
InterStim Stage 2
Stage 2 of the InterStim procedure allows for the actual surgical treatment of the device. If Stage 1 results were positive, surgery is scheduled and the device will be implanted by the sacral nerves in the lower back area. After surgery, a doctor will program the electrical signals in the device based on the results obtained in Stage 1.
After a couple of weeks of promising Stage 1 results, Stage 2 can be performed. It is an outpatient procedure where the pacemaker device is implanted under the skin and no wires will show outside the body. Patients are often given IV sedation during this procedure. There are two incisions made and the side that will be chosen for the implant will be determined by the side that had the best response during Stage 1.. There may be vibration, tingling, pulsing, pulling, or tapping sensations during the stimulation. After surgery, the device is programmed and patients are given instructions on how to turn the neurostimulator on and off, change the settings, or increase/decrease the stimulation amount.
After implantation, patients undergo 5-6 weeks of restricted activity to allow for the incisions to have time to heal and to prevent the lead wire from moving out of proper positioning. After 48 hours, patients may shower. About a month following Stage 2, patients will receive an implant ID card from Medtronic.
What’s the Difference Between Stages 1 and 2?
Stage 1 of InterStim therapy sets the test period to see if the device has viability as a treatment option for the patient prior to implantation surgery, or Stage 2. Both stages offer an operating system that provides patients with the freedom to control the stimulation or the quieting of bladder signals. There is more downtime with Stage 2 because of the actual implantation of the neurostimulator under the skin, while the Stage 1 trial is limited to an external device.
Contact the Incontinence Institute
The InterStim procedure gives many patients a chance to return to normalcy which allows for a higher quality of life. If you’re experiencing urinary incontinence, and have tried other treatment options, don’t wait any longer to seek treatment. Our team of medical professionals at the Incontinence Institute in Middle Tennessee is ready to help. Contact us today to schedule an appointment and learn more about our services. Together, we can help you regain control of your body and your life.