Originally Released: July, 1999
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HOPE FOR THOSE WITH BLADDER CONTROL PROBLEMS

A pacemaker-like device now offers significant relief for people with a variety of severe bladder control problems, say urologists at the University of Maryland Medical Center, one of the few teaching hospitals in the country that offers the treatment.

The recently approved Interstim device is implanted under the skin of a patient's abdomen to control nerve impulses to the bladder for relief of urge incontinence, urinary retention and urinary frequency/urgency.

"What makes this therapy so appealing is that we can try it out for a few days to see how it works before going ahead with an implant," says Toby Chai, M.D., a urologist at the University of Maryland Medical Center and assistant professor of surgery at the University of Maryland School of Medicine.

Previously, the device -- about the size of a stopwatch -- had proved useful for a majority of patients who had loss of bladder control. Now, says Dr. Chai, the implant is proving effective for many patients who have the need to urinate frequently and urgently dozens of times a day.

An estimated 13 million American men and women suffer from urinary control problems. "Approximately 85 percent of those who suffer are women between the ages of 30 and 59 -- women who are in the most active, productive years of their lives. For these women, the effects of incontinence are especially debilitating," says Dr. Chai.

The new device sends mild electrical pulses to the sacral nerves in the lower back that control bladder function. Based upon the electrical stimulation technology pioneered by Medtronic, Inc., for pacemakers, it represents a new category of bladder control treatment that could replace irreversible surgical options.

A simple painless test stimulation started in a physician's office can help assess whether the therapy will work. For several days, the patient wears an external Walkman-size device that generates electrical impulses through a thin wire to the bladder. The physician can, without surgery, adjust the strength of the electrical pulses to maximize the benefit for each patient. If it does not work properly, the device can be turned off or removed. If it does work, the patient is a candidate for having it implanted, a simple surgical procedure requiring only an overnight hospital stay.

The therapy helps those who suffer from symptoms of urinary urge incontinence, urinary retention or significant symptoms of urgency-frequency.

Those with urinary urge incontinence or significant symptoms of urgency-frequency may feel compelled to urinate as many as 40 times a day and often are embarrassed by wetting episodes. Although a variety of drug therapies are available to them, many people do not respond well to medication and are often resigned to managing their condition with absorbent diapers or pads.

People with urinary retention have difficulty emptying their bladder completely. They have few therapy options and manage their condition by self-catheterization.

"The importance of having this procedure done at a teaching hospital, like ours, is that we have experts on hand from a variety of disciplines and we can draw on the results of a number of academic studies on bladder problems," Dr. Chai says.

In clinical trials leading to FDA approval of the device, 82 percent of urgency-frequency patients experienced significant relief. They felt urgency only when their bladders needed to be emptied, rather than continually. After only six months, 47 percent of patients with urinary urge incontinence were completely dry, and 77 percent reported that they no longer experienced unexpected, heavy wetting episodes. After six months of the therapy, 53 percent of patients with urinary retention no longer needed a catheter.

"Many people who suffer from bladder control problems are unable to leave home, unable to work, unable to exercise or unable to participate in routine activities," says Dr. Chai. "With this new therapy, patients will experience fewer physical limitations and see an overall improvement in the quality of their lives."

Patients interested in the therapy may call 1-800-492-5538.

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This page was last updated on: March 21, 2008.