What is Overactive Bladder (OAB)?

Overactive bladder (OAB) is a common condition marked by frequent and sudden urges to urinate. The National Association for Continence states that approximately 33 million American adults experience symptoms of OAB. 

What are the Symptoms of OAB?

Do you feel like you’re always rushing to the bathroom? Do you find yourself waking up multiple times a night to urinate? There are many indications of an overactive bladder. Here are some of the most common:

• An intense urge to urinate
• Constantly visiting the bathroom for only a small amount of urine
• Waking up regularly during the night to use the bathroom
• Accidental leakage due to the inability to hold urine

Discussing your symptoms with a specialized physician will help determine your best treatment option. Several options exist, ranging from medications and surgical procedures to traditional and alternative methods.

Popular Overactive Bladder Treatment Options

• Bladder control medicine, such as antispasmodics, can help calm an overactive bladder and reduce symptoms. These drugs work by blocking the nerve impulses that cause bladder contractions. 
• Surgery, such as bladder enlargement, can be an option for those with severe cases of OAB. This procedure entails creating a larger bladder capacity to reduce the urgency and frequency of urination.
• InterStim therapy is a form of sacral nerve stimulation. It involves the placement of a small device under the skin in the lower back that sends mild electrical impulses to the sacral nerves to regulate bladder function. 
• Natural remedies for OAB include lifestyle changes, such as modifying your diet, practicing pelvic muscle exercises, and bladder training. Herbs like ginger and marshmallow root may also help reduce symptoms. 

Whether it be medications, surgery, InterStim therapy, or natural remedies, each option has its pros and cons and level of efficacy.

Natural Treatment for Overactive Bladder

While medication and surgery are popular treatment options, some individuals prefer to try natural solutions to manage their symptoms. Here are some of the most common, natural remedies for overactive bladder:

• Diet and Hydration: Limiting caffeine, alcohol, and spicy foods and drinking enough water can help improve bladder function.
• Pelvic Floor Muscle Exercises: Kegel exercises can strengthen the muscles that manage urination and improve bladder control.
• Bladder Training: Scheduling bathroom visits can help retrain the bladder and reduce frequency and urgency.

Herbal Remedies:

Gosha-jinki-gan

• Antispasmodic properties to reduce bladder contractions
• Traditional Japanese remedy for incontinence and frequent urination

Buchu (Barosma betulina)

• Native to South Africa
• Antibacterial, anti-inflammatory, and diuretic properties to improve bladder control

Capsaicin

• Found in hot peppers
• Blocks substance P to reduce bladder contractions
• Pain-relieving effect for bladder pain or discomfort

Note that the success of these natural remedies varies depending on the severity of an individual’s symptoms. Sometimes they may not provide enough relief, and other treatments may be necessary. 

InterStim Therapy: A Technological Approach

You may have heard about InterStim as a treatment option. But what is InterStim, and how does it work?

InterStim is an innovative solution for those with urinary and bowel dysfunction. It harnesses the power of sacral nerve stimulation to bring relief. This treatment process involves the placement of a device, no larger than a stopwatch, in the lower back region, which then sends gentle electrical signals to the sacral nerves to control bladder function. 

The advantages of InterStim therapy include its efficacy and that it’s less invasive than surgery. There are also disadvantages, such as the risk of infection and device malfunction.

According to a study, the success rate of InterStim for overactive bladder ranges from 50-80%. However, individual results may vary. Consult a physician to determine if InterStim is the best choice for your case.

Determining Your Best Options for Treating OAB 

Tips to consider when choosing a treatment option:

• Understand the severity of symptoms: Knowing your signs can help you choose the right therapy. For example, if your symptoms are mild, natural remedies and bladder training may be sufficient. But if your symptoms are severe, InterStim therapy or medications may be more appropriate.
• Personal preferences and lifestyle: Your lifestyle should play a role in your treatment decision. Natural remedies may be a good fit if you want a non-invasive option, but if you’re looking for a quick solution, InterStim therapy may be more appropriate.
• Consulting your physician: Consult a physician before starting any treatment for OAB. They can help you understand your options and determine the best course based on your case.

Find Out More About Overactive Bladder and Consult with a Physician 

Determining the best treatment option for OAB requires careful reflection and consultation with a physician. With so many choices, finding the right solution can be daunting. 

Our network of healthcare providers is committed to helping you control your bladder and your life. Forget searching through endless websites and medical journals. We offer personalized support and guidance right at your fingertips. Contact us today and a medical concierge will reach out to you. You can also reach us by filling out a urinary incontinence self-assessment. Everyone deserves a confident, healthy life. Don’t let OAB control you any longer.

The prostate is an organ that holds a unique significance in a man’s development from childhood to adulthood. It grows larger as the male grows older, and it’s typically with age that men begin to experience complications. For healthy adult males, the expectation is that the prostate won’t grow much larger than the size of a golf ball, but for others, it can grow significantly larger. This excess growth causes Benign Prostatic Hyperplasia (BPH). As the prostate grows larger, it puts increasing pressure on the urethra, resulting in the thickening of the bladder wall. This becomes the starting point of BPH, and issues relating to incontinence.

Treatment usually involves lifestyle changes or medication. It’s also not uncommon for minimally invasive procedures, or other surgeries, to be used as forms of intervention. This article will compare three common BPH treatment options: HoLEP, TURP, and Urolift.

Holmium Laser Enucleation of the Prostate (HoLEP)

During a HoLEP procedure, a physician uses a laser to remove part of the prostate tissue that’s squeezing the urethra and causing a blockage. HoLEP is an effective solution for relief for BPH patients who want to spend as little time as possible preparing, going through, and recovering from the treatment. A patient gets back to their normal routine, mostly, in the space of two weeks.

A downside to this treatment is that there is a 16% to 44% chance of incontinence reoccurring within three months following the surgery. However, if you’ve tried other common BPH treatments and haven’t found success, then you may be a suitable candidate for HoLEP treatment. This procedure may also be the preferred treatment option for patients who take blood-thinning medications as well, given that patients taking such medications aren’t often cleared for other surgical procedures. Be sure to discuss your unique case and symptoms of BPH with a physician.

Transurethral Resection of the Prostate (TURP)

Similarly, a TURP procedure serves to mitigate the effects of an enlarged prostate on the urethra. The treatment involves passing a resectoscope through the urethra, where an electrically heated piece of wire then cuts away the necessary sections of the prostate to relieve pressure on the urethra. A catheter is then inserted into the urethra and flushed with fluid to help clear removed pieces of the prostate.

The TURP process is done under local anesthesia and typically takes about sixty to ninety minutes. As an inpatient procedure, the length of the hospital stay is generally two to three days. Patients are usually advised to avoid any strenuous work including, but not limited to, driving, exercise, and sex during the first few weeks of recovery. Normal functionality can be expected to return within about six weeks. A TURP procedure does affect ejaculation, but not the sensation that accompanies it. Some men have reported having trouble, temporarily, controlling their bladder. Erectile dysfunction and UTIs are also possible, but rare. 

Undertaking this procedure is best for patients facing stronger BPH symptoms, and is ideal for males who no longer have wishes to procreate. Consult with a physician to determine your candidacy for a TURP procedure.

UroLift

A UroLift procedure lifts an enlarged prostate by way of tiny implants and ensures the urethra is not blocked. Nothing in the form of cutting, removal, or heating of prostate tissue is necessary to conduct UroLift treatment.

One of the most desired benefits of a UroLift procedure is the preservation of normal sexual function. It can also be performed under local anesthesia. Similarly beneficial, recovery times and the resumption of normal, daily life are often much faster than other surgical procedures.

Side effects from this treatment are among the mildest. They include a burning sensation during urination, blood in the urine, painful urination, or lower abdominal pain. However, these tend to resolve within 2 to 4 weeks of their first appearance.

UroLift works for any man currently dealing with BPH, especially younger men looking to maintain their sexual activity. 

Comparing BPH Treatments

Each of these procedures is effective in treating BPH. What sets them apart are the recovery times, risks, and costs. If you’d like to return to your daily routines in the shortest time possible, then HoLEP may be a suitable option. TURP, on the other hand, brings the fewest risks and complications and is often used to treat issues brought on by the other treatment options. 

Consulting with a physician will provide you with a comprehensive understanding of each procedure, including risks, postoperative symptoms, and what to expect during your recovery period.

Are You Suffering From Incontinence?

Our network of healthcare providers is committed to helping you control your bladder and your life. Forget searching through endless websites and medical journals. We offer personalized support and guidance here in Middle Tennessee. Contact us today and a medical concierge will reach out to you. You can also reach us by filling out a urinary incontinence self-assessment. Everyone deserves a confident, healthy life.

The inability to control your bowel movement until you reach the bathroom can be embarrassing, and you may feel inclined to try and hide the problem. Also known as bowel incontinence, leaking stool (feces) from your rectum can happen when passing gas. In addition, it can occur when you have no idea you need to use the bathroom.

Some common causes of fecal incontinence include rectal prolapse (rectum drops down to the anus), rectocele (rectum protrudes through the vagina), hemorrhoids, surgery, nerve or muscle damage, and constipation. Additionally, various factors may increase your risk of developing bowel incontinence like being an adult of over 65 years, complications during childbirth, late-stage Alzheimer’s disease and dementia, and physical inability that leads to rectal nerve damage.

Depending on the cause, your physician may advise you on various treatments, including taking supplements to improve or reduce fecal incontinence to enhance your quality of life.

Best Supplements for Fecal Incontinence

The following supplements for bowel incontinence are considered safe to use and effective for reducing fecal incontinence symptoms:

1. Gasha-jinki-gan 

This Japanese blend of 10 natural herbal ingredients works by halting nerve signals to the bladder. As a result, your urge to pass stool decreases, aiding in urine and fecal incontinence. According to the National Library of Medicine, Gasha-jinki-gan is safe and effective for women with overactive bladders.

2. Saw Palmetto

A study from the National Library of Medicine concluded that the consumption of Saw Palmetto, a herbal supplement made from the berries of a palm native tree, for 12 weeks relieved overactive bladder symptoms such as urinary incontinence, frequent urination, and urinary urgency.

3. Vitamin D

Vitamin D is an essential micronutrient for optimal muscle function. A deficiency in vitamin D puts you at a high risk of experiencing pelvic muscle floor disorders like fecal incontinence. You can take a test to determine your vitamin D levels through a blood test in a hospital. The normal range is between 20 and 40 ng/mL. Therefore, if the test results are outside this range, you should supplement your diet with foods or supplements rich in vitamin D. 

4. Zinc

A study by the National Center for Biotechnology Information among patients suffering from fecal incontinence showed that the application of zinc-aluminum-based ointment decreased fecal incontinence symptoms. 

5. Magnesium

Magnesium helps to increase water in the intestines, helping in bowel movement. Often, it is used to help people suffering from constipation. In addition, magnesium plays a significant function in energy production, nerve function, and supporting muscles.

Fiber Supplements for Fecal Incontinence

If you are suffering from fecal incontinence, consider fiber therapy. Fiber therapy includes a gradual fiber intake until you achieve the recommended daily intake with respect to your age. For example, a woman aged above 50 years should eat 21 grams of fiber per day while a man above 50 should consume 30 grams per day.

Your body experiences slower metabolism, less muscle mass(sarcopenia), and reduced physical activity as you age. For this reason, consuming a diet that can help your digestive system function normally may ensure that you live comfortably even at old age. 

Fiber helps alleviate bowel incontinence by absorbing water and bulking up fecal matter. In addition, it relieves constipation, which is a major cause of leaking liquid out around a blockage. You can increase your fiber intake by:

• Eating fresh and raw vegetables and fruits
• Consuming whole grains and cereals like beans
• Using fiber supplements

While fiber may improve your fecal incontinence symptoms, it doesn’t completely clear the issue. Visit your physician to receive extra treatments or advice on bowel management to lead a healthy and normal life.

How Can You Stop Bowel Incontinence Naturally?

Apart from using incontinence supplements like pumpkin seeds, soy milk, barley water, and diluted squash, dietary modifications and lifestyle changes can help alleviate the symptoms or prevent fecal incontinence.

Dietary Modification

Difficulty in controlling your bowel movement is manageable by being keen on the foods you consume. In addition to closely monitoring your diet, consult with your doctor to ensure that you’re receiving the right amount of nutrients to function optimally.

Consider the following to reduce your fecal incontinence symptoms:

• Keep a food diary to track the foods that worsen the situation
• Eat small portions of food but frequently throughout the day
• Drink enough fluids
• Include supplements for incontinence like fiber

If you experience loose stool(diarrhea) during bowel incontinence, limiting or avoiding certain foods can help. They include:

• Alcohol
• Gas-producing foods like legumes
• Dairy products
• Caffeine
• Nicotine from chewing or smoking tobacco 
• Foods high in fat like deep-fried foods
• Drinks and foods rich in sugar

Lifestyle Changes

Making some lifestyle changes can help you manage an existing fecal incontinence issue or prevent it. The lifestyle changes are:

• Including pelvic strengthening exercises like squats, walking, and kegal
• Avoiding bladder irritants like alcohol and caffeine
• Use of catheters as advised
• Shedding off some weight if you are obese or overweight
• Trying pads and collectors to protect your clothes from leakage

What Are The Treatment Options for Fecal Incontinence?

Your treatment option depends on the cause of fecal incontinence. The options vary, and they include;

1. Sacral Nerve Stimulation

Sacral nerve stimulation is a medical electrical stimulation approved by the FDA to treat urinary retention and overactive bladder. The therapy is used as a last resort for those who have tried and failed medical management and treatment. This procedure includes using a device that sends mild electrical pulses from a handheld device that adjusts the stimulation level to the sacral nerves, reducing bladder control problems and symptoms.

The two common devices used for sacral nerve stimulation are Interstim and Axonics. Interstim has a battery that can last up to 15 years, but you cannot have an MRI done below the head. Axonics is rechargeable after every two weeks using a special belt, smaller in size than Interstim, and is MRI-compatible. 

2. Hemorrhoid Banding

Hemorrhoids are pockets of swollen veins in the anal canal and can cause fecal incontinence due to straining during bowel movements. Hemorrhoid banding or rubber band ligation is a minimally invasive procedure that cuts the hemorrhoids’ blood supply, providing relief during bowel movements.

3. Medication

After a diagnosis and medical test, your doctor may prescribe you medicine depending on the cause of your bowel incontinence. They may include:

• Bulk laxatives like Psyllium( Metamucil) for chronic constipation causing incontinence
• Anti-diarrhea drugs like Lomotil(atropine sulfate) or Diphenoxylate

4. Physical Therapy for Bowel Incontinence

If your bowel incontinence is due to muscle damage, your doctor may recommend the following physical therapy to improve anal sphincter control and increase bowel movement awareness.

• Kegel exercises to contract your inner muscles
• Biofeedback through specially trained physical therapists to teach you how to increase your anal strength with the help of a rectal balloon or anal manometry
• Bowel training by making a conscious choice of when to visit the bathroom

Regain a Sense of Normalcy

At Incontinence Institute, we provide you with an individualized treatment plan depending on the cause of your incontinence. In addition, our team of healthcare providers will treat you with utmost respect and care as they are sensitive to your situation. Contact us today for help with fecal incontinence. Our medical concierge will get back to you as soon as possible.

Persistent abdominal pain from gallstones may lead to a physician recommending gallbladder removal. The removal of the gallbladder usually causes a lot of concerns to a patient and their families. As a patient, you will start asking questions about what life is like post the surgical process, whether life will be normal and post-surgery effects that may change the trajectory of your life. With gallbladder removal, life should be normal with minimum life alteration. However, some people experience long-term effects. Here are some of the long-term effects of gallbladder removal.

What is the Function of the Gallbladder?

The gallbladder is a thin-walled pear-shaped sac located beneath the liver. It is responsible for concentrating and storing bile from the liver and releases bile into the small intestine to enhance the breaking down and absorption of fats from food. Research indicates that the gallbladder usually holds about 30 to 80 milliliters of bile fluid. It functions by releasing bile by contracting and squeezing through the bile duct when food reaches the small intestine. 

Gallstones Complications

The gallbladder may experience a gallstone complication leading to a cholecystectomy. The term “gallstones” is often associated with severe abdominal pain, which is not the case among most people. However, when the symptoms of gallstones persist, your physician may recommend a procedure for removing the gallbladder.

Symptoms of Gallstones

Here are some of the symptoms of gallstone that may lead to gallbladder removal:

• Intolerance of fatty foods
• Abdominal bloating
• Severe pain in the upper abdomen lasting more than 30 minutes
• Back pain, particularly between your shoulders and beneath your right shoulder.
• Nausea or vomiting

Gallbladder Removal Side Effects

Generally, gallbladder removal effects may be felt in the first six months after the procedure. However, in some cases, it may have long-term effects on individuals. Some of these long-term effects include

• Diarrhea
• Constipation
• Fatty food intolerance
• Flatulence, or the accumulation of gas in the alimentary canal

Most of the impacts of gallbladder removal may be felt by lifestyle and dietary changes one makes in their schedule. Individuals may also find it difficult to handle hard tasks post-removal. In case of severe effects, it is important to consult your physician for further guidance.

Learning to Cope With These Effects

It is important to understand the various coping mechanisms you can adopt after removing the gallbladder. Adjustments may feel uncomfortable at first, but with time one gets used to them and adopts a new way of life. Some of the ways to cope with these effects of gallbladder removal include the following:

Limit Fat Intake: Gallbladder removal may reduce the action of bile. It is important to reduce fat intake since one may become fat intolerant. As a dietary adjustment, one should consume steamed, baked, boiled, or grilled foods and avoid fried foods which contain fats.

Lifestyle adjustments: It is important to adjust your lifestyle and activities in the long term to enhance comfort. One needs to be aware of their condition and be mindful of their activities, such as exercises, what to ingest, and the duration between eating to avoid challenges such as bloating.

Incontinence After Gallbladder Surgery

Most people who have experienced gallbladder removal live a normal life. However, proper adjustment often comes with adequate coping mechanisms, such as lifestyle changes and limiting fat intake, so one can easily adapt post-surgery. A small percentage of patients also experience incontinence after gallbladder surgery. If you’re experiencing incontinence as a result of gallbladder surgery, contact us to speak to a medical concierge about your symptoms and find the right solution. The Incontinence Institute offers a network of specialized physicians focused on long-term solutions. You can also reach us by phone at 1 (615) 434-8661 or by filling out a fecal incontinence self-assessment or urinary incontinence self-assessment.

Parkinson’s Disease is an incredibly complex disorder with an array of degenerative symptoms that can manifest a little differently in every person with the disease. This leads to questions and concerns related to the direction of your, or your loved one’s, health. When these concerns are sensitive in nature, such as the relationship between Parkinson’s and incontinence, the questions can become more difficult to ask. 

But knowledge of both urinary and bowel incontinence is important to talk about because both problems can arise and addressing them is essential for informed, supportive, and effective care. 

Does Parkinson’s Cause Incontinence?

Parkinson’s Disease can cause both bowel and urinary incontinence as part of its degenerative nature, though not always at the same time. These symptoms, when they appear, can be addressed in several ways as long as they remain a part of the dialogue between you and your caregivers, whether they be family, friends, or professionals. 

What Kind of Incontinence Does Parkinson’s Disease Cause?

Incontinence is considered a non-motor symptom of Parkinson’s Disease, which is mainly considered to be a movement disorder. This means that much more research and emphasis have gone into the more noticeable motor issues that define the disease and not the prominent non-motor problems that accompany the disease. 

This also means that the medication prescribed already to control a person’s motor functions doesn’t necessarily have any effect on non-motor-related symptoms, such as incontinence, which need to be addressed separately and discussed with your doctor. Identifying and treating incontinence issues aren’t just about increasing personal comfort. It’s about dignity. It’s about confidence. It’s about quality care.

Parkinson’s and Urinary Incontinence

Parkinson’s causes problems with automatic bodily functions, such as breathing, heart rate, and urinary function. Urinary incontinence is much different than fecal incontinence and usually doesn’t start to occur until the later stages of the disease. Urinary incontinence due to Parkinson’s is a two-fold problem. The bladder has trouble holding urine in, but, at the same time, it’s difficult to control the release of urine, leading to some serious discomfort and emergency bathroom visits. 

Urinary incontinence problems can come in many forms:

• Functional Bladder Incontinence
• Mixed Incontinence
• Overflow Incontinence
• Pelvic Prolapse
• Reflex Urinary Incontinence
• Stress Urinary Incontinence
• Urge Incontinence
• Erectile Dysfunction

A person with Parkinson’s may have to urinate very frequently, complicated by an increasingly difficult time with movement. Once they sit down, they may find it difficult to let go of the urine and void their bladder. While nearly 40% of Parkinson’s patients may experience some level of urinary incontinence, only 15% of patients should develop a serious urinary condition. 

Parkinson’s and Fecal Incontinence

Did you know that 65% of Parkinson’s patients are affected by constipation, and, many times, the constipation is severe? The beginning stages of fecal incontinence start to occur immediately due to behavioral changes that can even preclude a diagnosis. For example, when someone starts to notice that their hand is shaking a little, they may be nervous about spilling something and reduce their intake of fluids. The trembling hand may be what causes you to call the doctor, but bowel problems have already begun.

Fecal incontinence also comes in several forms, including: 

• Double Incontinence
• Fecal Incontinence
• Flatus Bowel Incontinence
• Passive Bowel Incontinence
• Rectal Leakage
• Urge Bowel Incontinence

Parkinson’s Disease slows down our gastric motility function, which means that our ability to digest food and move waste through our system has slowed way down. When you mix this with all the medication that a person with Parkinson’s has to take and the fact that they aren’t always getting enough water or movement, constipation is an unfortunate side effect. 

This means that a person with Parkinson’s can suffer from bowel impaction that needs to be removed or experience a loss of muscle control that can lead to accidents, and near-accidents, that can keep someone with the disease from living their best life. What can be done to treat incontinence in Parkinson’s patients?

What Can Be Done For Incontinence As A Result of Parkinson’s Disease?

When incontinence becomes a problem, there are several interventions that can be done, depending on the cause of the loss of function, whether it’s behavioral or medical. 

Lifestyle Changes

Your diet will have a big impact on your ability to get back the control that you have lost. Certain foods can irritate your bowels, cause inflammatory reactions, and lead to incontinence problems. There may even be foods that bother you that may not bother another person in the same state. A great idea is to have a journal that documents what you have eaten, when you ate it, and how much you ate along with details from your bathroom visits to help your doctors identify problem foods not already on the list. 

Along with a healthier diet, walking more, and generally moving around more, will help move waste along your bowels and help you know when it’s time to go. 

Exercises

Did you know that there are physical therapy options for incontinence? Physical therapy has been pretty effective, especially for fecal incontinence, and can be used alongside a great diet and daily behavioral changes before any medication may be introduced. The goal is to strengthen your pelvic floor muscles, such as doing kegal exercises throughout your day.

Bowel training with a routine schedule can help you retain your bowel habits as well. Biofeedback is a way to retrain your bowel muscles by utilizing noninvasive sensors attached to the outside of your abdomen. It’s all about strengthening and retraining those muscles weakened by medication and disease. 

Medications

Once your diet has been optimized for better digestive control, and incontinence is still a problem, medication may be helpful. But medication can be tricky and certain medications have been known to make problems worse or not mix well with other medications. If this is the next step in your plan, even OTC medications can have a harmful effect and you should report everything you take to your doctor. It’s essential to identify the source of your problems before treating them. 

Sacral Nerve Stimulation

Your sacral nerve communicates important messages between your urinary tract, digestive tract, and your brain. These messages give you fair warning before you need to use the restroom and let you know when you are about to enter into a situation that could be messy and uncomfortable. There are a few non-invasive nerve stimulation options available to those who are interested. Options include:

• InterStim Implants work for both bowel and urinary incontinence by using an internally implanted device that sends electric pulses to stimulate sacral nerves to increase your body and mind’s ability to communicate messages between your digestive tract and the brain. This should fully restore a person’s ability to use the restroom as intended, but is usually only an option when medication and behavioral modifications fail to help.
• Axonics is another implant that works for both bowel and urinary incontinence and that also stimulates the sacral nerve, increasing the ability of your gut to communicate with your brain.

Both of these procedures are outpatient and usually only use a local anesthetic for implantation. You will be given a hand-held remote to control the devices and should be back on your feet soon. There are a few differences between these two particular options. While both implants are small and can’t be felt under the skin, Axonics is still a smaller device and requires charging once a month, for an hour. On the other hand, the InterStim II device doesn’t need charging but requires replacement every five years, unlike Axonics, which needs replacement every fifteen years.

The InterStim Micro needs to be charged once a week for 20 minutes, but also only needs to be replaced every fifteen years. You will need to discuss your options with your doctor and an incontinence specialist, who can help you determine which treatment is best for you and your life.

Don’t suffer in silence; we hear you and we see you. 

Contact us at the Incontinence Institute for further information on living your life comfortably and confidently.

Vanderbilt University Medical Center Joins Medtronic InterStim Micro ELITE Study

Vanderbilt University Medical Center is joining Medtronic’s ELITE clinical study of patients receiving the InterStim Micro sacral neuromodulation device. “Very, very few patients are offered advanced therapies and what we are able to accomplish at Vanderbilt is offer patients who have failed behavioral and medical therapies an opportunity to regain their quality of life,” said Dr. Melissa Kaufman, MD, PhD, professor of Urology and chief of the Division of Reconstructive Urology and Pelvic Health at Vanderbilt University Medical Center.

VUMC’s ELITE Study Participation

The ELITE clinical trial will enroll up to 40 medical centers, including VUMC, to study 200 patients for two years. The goal is to better understand how living with the InterStim Micro impacts both their bowel and bladder control issue and their everyday lives. “[The InterStim Micro] is an exceptionally powerful technology and the ELITE study is one of several clinical trials for these devices that we have been involved in through the years,” said Dr. Kaufman.

Dr. Kaufman’s team implants an average of 10 to 15 devices per month and has been performing surgeries since the device was approved in 1997. Sacral neuromodulation is an area of significant advancement in treating pelvic floor issues and offers immense relief to patients.

Incontinence: Widespread and Undertreated

Bowel and bladder incontinence affects almost one out of every six Americans, an estimated 37 million people. The causes are wide-ranging, including neurological disorders, enlarged prostate or prostate cancer, childbirth, hormone loss such as during menopause, an injury to the back or pelvic region, and a number of other health conditions. 

In addition to the physical symptoms, Dr. Kaufman said 90% of patients who have urgency incontinence also report mental health issues. Fear of leakage and the attached stigma causes those affected to withdraw from everyday life and experience isolation, depression and feelings of hopelessness. 

Dr. Kaufman noted having observed this in her patients: “Patients are reticent to discuss it with their providers and therefore are undertreated. I have patients who have lost the capacity to go about any of their normal daily activities and avoid any company because of their fear of leakage.”

InterStim Micro Upgrades, Surgery and Recovery

The InterStim Micro device is the latest iteration of Medtronic’s endeavor to improve the reduced quality of life so many people experience. It’s a new version of the original device that’s been in use since 1997 when it was first approved by the FDA. 

Unlike the previous model, the InterStim Micro has a rechargeable battery and allows for full-body MRIs without needing to be removed. The device works by helping the bladder reprogram how it senses filling and storage of urine, in order to reduce instances of urgency incontinence, said Dr. Kaufman. It stimulates peripheral nerves that send messages to the bladder. 

During outpatient surgery, two small incisions are made above the buttocks near the sacrum, and the device is implanted. Recovery is relatively minimal, with pain medication for several days after surgery and only light activity for several weeks. 

Did you know that up to 11% of the male population suffers from urinary incontinence? This is a lower percentage than for women, but, this does not diminish the fact that millions of men must cope with urinary incontinence. If you are a man who suffers from UI, know that you are not alone.

Types of Incontinence

The types of incontinence in men are comprised of three main categories: Stress Incontinence, Urge Incontinence, and Overflow Incontinence. Stress Incontinence means that a person will lose urine involuntarily when their body is put under stress, possibly from lifting heavy objects, coughing, or even laughing. Urge Incontinence is when a person feels a sudden, urgent, and unstoppable urge to urinate. Finally, Overflow Incontinence means that urine leaks consistently and is characterized by frequent urination, often in small amounts. Those who suffer from incontinence may experience one, two, or all three of these types.

Central Nervous System (CNS)

Male Urinary Incontinence is often associated with nervous system problems. Diabetes has the potential to cause nerve damage over time, which can result in loss of bladder control. And, a stroke, Parkinson’s Disease, and Multiple Sclerosis can all cause urinary symptoms. The Central Nervous System (CNS) is critical to proper bladder function, so anything which interrupts nerve signals to the bladder has the potential to result in incontinence.

Prostate Related Incontinence

While nervous system related incontinence is possible for both men and women, the prostate presents a uniquely male cause for Urinary Incontinence. As a man ages, a process called Benign Prostate Hyperplasia (BPH) can occur, which simply means that the prostate has increased in size. As the prostate enlarges, it can begin to put pressure on the urethra. This pressure can result in a number of urinary symptoms, ranging from hesitancy to urge incontinence. When this happens, difficulty starting and maintaining a stream of urine is common, and, Overflow Incontinence also frequently reported. While removal of an enlarged or cancerous prostate may seem like the solution to this problem, Radical Prostatectomy, the total removal of the prostate, can result in Urinary Incontinence symptoms of its own.

As always, prior to self-diagnosis and taking symptom management into your own hands, meet with a medical professional to receive a diagnosis and implement a treatment plan. Our board-certified, industry-leading physicians address the needs of patients suffering from Urinary and Fecal Incontinence with customized treatment plans, supported by cutting-edge technology and procedures.

If you are suffering any of the above symptoms, or if bladder overactivity is drastically affecting your daily life, reach out to one of our medical professionals to see how you can restore yourself to a higher quality of life. Call 1.615.547.2938 to schedule a consultation today, and let us empower you to live the leak-free life you deserve.

Resources:

• https://www.medicinenet.com/urinary_incontinence/article.htm#how_is_urinary_incontinence_ui_in_men_diagnosed
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476070/

Nocturia refers to nighttime urination – people who have nocturia wake up frequently to use the bathroom. Though all incontinence is characterized by its disruption of daily life, nocturia is particularly impactful because it interrupts a key human function – sleep. So, alongside frequent urination, leaks, and the inability to control one’s bladder, individuals who wake up two or more times at night to use the restroom often suffer from lower quality sleep. Consistent sleep disturbance can translate to lethargy during waking hours and may contribute to the development of depression, dysfunctional mood regulation, as well as the incidence of type 2 diabetes (T2D), obesity, and cardiovascular disease.

What Causes Frequent Nighttime Urination?

Nocturia can be a side effect of underlying bladder issues, a medication side effect, as well as symptom of an underlying medical condition. However, causes may also be impacted by individual behavior. Nocturia may very well be a byproduct of the beverages that an individual consumes – particularly those close to bedtime. Caffeinated drinks like soda and coffee, as well as alcohol, can contribute to this problem. In some cases, individuals are simply drinking too much right before bed.

There are several different reasons people may actually make more urine at night, which can be one cause of nocturia. These are as follows:

• Nocturnal polyuria: When the body produces greater-than-average amounts of urine at night. While you sleep, your body produces smaller amounts of more concentrated urine, in comparison to your waking hours. Ideally as a result an individual is able to sleep 6-8 hours without interruption. An individual may be diagnosed with nocturnal polyuria when their nighttime urine volume exceeds 20-30% of their total urine volume over the course of one day.
• Global polyuria: Just like nocturnal polyuria, this is an overproduction of urine. However, this overproduction occurs during waking hours, as well.

Outside of these causes, the onset of nocturia in women may be triggered by the impacts of pregnancy or childbirth, menopause, and/or pelvic organ prolapse. In contrast, nocturia in men may be attributed to an enlarged prostate. In both men and women, it is critical to have a health care provider determine if the nocturia is from a lower urinary tract or systemic cause.

How to Stop Frequent Urination at Night

As always, prior to self-diagnosis and taking symptom management into your own hands, meet with a medical professional to receive a diagnosis and implement a treatment plan. Our board-certified, industry leading physicians address the needs of patients suffering from nocturia with customized treatment plans supported by cutting-edge technology and procedures.

If you are suffering any of the above symptoms, or if bladder over activity is drastically affecting your daily life, reach out to one of our medical professionals to see how you can restore yourself to a higher quality of life. Call 1.888.741.6403 to schedule a consultation today, and let us empower you to live the leak-free life you deserve.