Implants for incontinence
Ian Goldman, MD, is a urologist on staff at Banner Del E. Webb Medical Center. His office can be reached at 623-546-1400.
Question: I deal with incontinence and it is quite embarrassing. I’ve tried the medication they have for it, but I was just diagnosed with glaucoma and told I can no longer take it as it will make the glaucoma worse. I’m desperate for help. I’ve heard about an implant that helps urinary incontinence. How does it work?
Answer: You are right that there is a treatment option for some people who suffer with urinary incontinence for whom prescription medication, surgery and other treatments have not worked. Glaucoma patients should not take the drugs, called anticholinergics, prescribed to treat incontinence. The treatment involves an implantable device that delivers mild electrical current to the sacral nerve located near the base of the spine.
The sacral nerve controls the bladder and muscles related to urinary function. When there is a miscommunication between the brain and the sacral nerve, urinary problems can result. The sacral nerve implant is an option for some people.
Before the device is implanted, patients are given a trial assessment of three to seven days. A thin wire is placed on the patient’s back and attached to a small stimulator, which the patient wears on a belt. Mild electrical impulses are sent to one of the sacral nerves. This trial period evaluates whether or not the patient responds to the treatment with improvement in bladder control.
The next step is actually implanting the device, which is placed on the upper buttocks just under the skin, much the way a heart pacemaker is implanted. Thin wires are situated at the sacral nerve under the skin. This minor surgery is completely reversible. As with any medical treatment there may be side effects, such as pain at the implant site, infection or skin irritation, or numbness at the implant site, but these can usually be resolved.
Patients who are dealing with incontinence should discuss treatment options with their physicians. SNS may be an option for patients who have not found relief with other types of treatment.