Interstim Neurostimulator Implant for Faecal Incontinence

Interstim Neurostimulator Implant for Faecal Incontinence

Introduction to Procedure

We know that undergoing any procedure is a scary experience.  We understand the worry and anxiousness that is associated with surgeries and procedures and aim to walk the road to recovery with you every step of the way. We put this information together using the very helpful handbook, ‘Handbook of Surgical Consent” from Rajesh Nair and David J. Holroyd.  We hope that the following information will answer all your questions and help you with the preparation phase for your procedure.

Description of procedure

There are several treatment options for overactive bladder or bowel incontinence, including Medtronic’s innovative InterStim® neurostimulator. It’s been used to treat more than 150,000 people worldwide since 1994. If your life has been disrupted by bladder problems and other treatments have not worked for you or have caused intolerable side effects, talk to your doctor about how you can get back to normal.

If you've tried other treatments for your overactive bladder without success, you may want to consider an evaluation of sacral neuromodulation with InterStim Therapy. Sacral neuromodulation has been available since 1994 and has been used to treat more than 150,000 people around the world.

 

Download the brochure (Interstim-pg-bowel.pdf)       

 

What is InterStim® Therapy?

InterStim® Therapy (also called sacral nerve stimulation or sacral neuromodulation in the literature) was developed in the early 1980s and was approved in Europe in 1994. It can improve quality of life by eliminating or greatly reducing the symptoms suffered by patients with:

  • Faecal incontinence
  • Constipation

InterStim® Therapy helps to restore normal nerve activity so that you can defecate normally. It uses a small implanted medical device to send mild electrical pulses to a nerve located just above the tailbone.

InterStim® Evaluation Phase

InterStim® Therapy is performed in 2 phases:

  • Evaluation phase
  • Implant phase

Patients who experience relief from their symptoms during the evaluation phase may be candidates for a permanent implant like more than 100,000 patients worldwide.

Evaluation Phase

An electrode - a thin wire - is inserted near the nerves in your lower back that control the bowel. This electrode is then connected to an external stimulator, which delivers mild electrical pulses to the nerves. This procedure normally takes less than an hour and can be done under local anaesthesia.

Your Follow-up Visit

At the end of the evaluation phase, you will meet with your doctor to review your bowel diary, to check if your symptoms have improved and to decide if the therapy is appropriate for you.

Operative techniques

Implant Phase

If you performed the evaluation phase with a temporary electrode, then a permanent electrode will be implanted close to the nerves in your lower back. If the evaluation phase has been performed with a permanent electrode, this procedure can be avoided. The electrode is then connected to the small implantable neurostimulator which will be inserted under the skin in the upper buttock where it will be most comfortable and cosmetically acceptable for you. This minimally invasive procedure may take an hour and can be done under local anaesthesia.

Preparing for the Procedures

You may have regular meals on the day before the test, but please do not eat or drink anything after midnight on the day before the test. This also includes chewing gum, mints and hard candies.

You may take certain necessary medications with a small sip of water up to two hours before the test. Please check with your doctor regarding any medications you take.

Notify the nurse or doctor if you are diabetic. Follow your doctor’s instructions regarding insulin dosage and when to take your pills for diabetes.

You will remain awake for the procedure.

After the Procedure

You may resume your normal daily activities.

Your implantable neurostimulator will run continuously (24h/day) for many years and will be invisible under the skin incision wound. Once at home, gradually increase your activity level as your incision heals. On your doctor’s advice, you will be able to resume an active lifestyle. Your awareness of the neurostimulator will gradually diminish, and you may not even feel its presence.

Normally your doctor will schedule a visit at 1 month after the implant to check the efficacy of the stimulation parameters and to adapt them accordingly. Sometimes, several visits are necessary to fine tune the settings during the first 3 months. Otherwise, you may only need a yearly check-up.


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