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Introduction to sacral neuromodulation therapy for urinary bladder dysfunction using an InterStim system

14 May 2020
Professional
02 May 2020
Volume 29 · Issue 9

Abstract

Sacral neuromodulation is an internationally endorsed therapy recognised by the National Institute for Health and Care Excellence for patients who have refractory overactive bladder symptoms and/or idiopathic non-obstructive urinary retention when conservative treatments have failed or when patients have been unable to tolerate them. The Medtronic InterStim System used at the Queen Elizabeth Hospital Birmingham received CE mark approval in 1995 for bladder indications. To date, over 300 000 patients worldwide have been treated, with 61–90% reporting satisfaction with treatment (Sutherland et al, 2007; Leong et al, 2011). It is a safe and effective intervention that can positively impact upon the management of both of these conditions, in particular overactive bladder. This highly prevalent condition is distressing to the individual and has an economic burden to society comparable in magnitude with that of breast cancer and osteoporosis (Hu and Wagner, 2005).

Bladder problems in general are common and can affect men and women of all ages. It is estimated that, in the UK, 14 million people live with bladder problems, which also affect 900 000 children and young people (NHS England, 2018).

Many suffer in silence because embarrassment makes them reluctant to discuss their condition with family members or to seek medical care. Consequently, because bladder dysfunction is such an emotive condition that has both physical and psychological effects, it can have a profoundly negative effect on the individual and family. Patients who suffer from bladder overactivity are often preoccupied and concerned with constantly locating the nearest toilet, looking for aisle seating and estimating the amount of time until their next break (Kinsey et al, 2016). It impairs psychological and emotional wellbeing and is linked with high rates of anxiety and depression, while affecting daily activities, sexual function and work productivity (Rigby, 2014).

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Sacral neuromodulation
Urinary retention
Overactive bladder
Safe
Effective
Economic burden