If you suffer from severe urinary incontinence and other treatments have not been effective, you may be a candidate for electrical stimulation or neuromodulation therapy.
This form of therapy can be effective in treating urge incontinence – accidental leaks associated with an overactive bladder. Neuromodulation may also be helpful if you’re not able to urinate completely and might require catheterization.
How electrical stimulation works is not well understood, but medical experts believe the stimulation improves the communication pathways between your brain and your bladder, similar to how a pacemaker corrects abnormal impulses in the heart. If your bladder sends too many or too few impulses to the brain, electrical stimulation makes those impulses more regular so the brain responds appropriately.
There are two main types of neurostimulation:
Posterior tibial nerve stimulation (PTNS) can be done in the doctor’s office. A very small electrode is inserted through the skin on your lower leg. The electrode communicates with an electrical stimulator outside the body that sends pulses to the implant, which stimulates the tibial nerve in your leg. The electrical current then travels to the nerve in your lower back that’s responsible for bladder and pelvic floor function.
This treatment is typically done once a week for 12 weeks with sessions lasting about 30 minutes. Your doctor may recommend maintenance sessions after that depending on your response to the therapy.
Sacral nerve stimulation (SNS) involves implanting an electrical stimulator under your skin above the buttocks. The stimulator looks similar to a pacemaker and is attached to electrodes that send pulses to a nerve in your lower back (sacrum). The sacral nerve helps control bladder functions.
Before surgically implanting the device, your doctor will likely perform a simple test in the office to see if stimulating specific nerves helps your symptoms. Ask your doctor about taking medication to help you relax if you’re feeling anxious.
During the test, you may feel a tingling sensation like pins and needles. There’s usually very little pain, if any. If the test is successful, your doctor will implant the device later in a procedure room while you’re under anesthesia.
The estimated life of the implantable device is four to five years, with periodic visits to your doctor for maintenance and reprogramming.
Talk with your Mercy urologist, who will help you decide if neuromodulation therapy is right for you. At Mercy, we understand how frustrating and disruptive urinary incontinence can be. Our goal is to give you the relief you need, so you can stop looking for a bathroom and start looking for new ways to enjoy life.