| October 2006 · Vol. 18, No. 10 Pelvic Surgery Update
New Developments that are Changing Patient Care
Interstim: An implantable device for implacable urinary symptoms
Urge incontinence, urgency–frequency, and retention may yield to electrical stimulation
Deborah
L.
Myers,
MD;
Associate Professor of Obstetrics and Gynecology, Brown Medical School, Women and Infants Hospital of Rhode Island, Department of Obstetrics and Gynecology Director, Division of Urogynecology and Reconstructive Pelvic Surgery Providence, RI Vivian
W.
Sung,
MD, MPHAssistant Professor of Obstetrics and Gynecology, Brown Medical School, Women and Infants Hospital of Rhode Island, Department of Obstetrics and Gynecology Division of Urogynecology and Reconstructive Pelvic Surgery Providence, RI
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Fast Track
Quality of life scores improved significantly
Pain, wound problems, or lead fracture led to surgical revision in 15.5%
It was unclear whether there was a significant placebo effect on fecal incontinence
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Sacral neuromodulation stimulation (SNS) offers a less invasive alternative treatment for a difficult challenge: how to improve quality of life for patients with refractory lower urinary/pelvic floor disorders. In the past, the options were limited to radical surgical procedures such as urinary diversion, augmentation cystoplasty, or cystectomy.
The neuromodulation technique has been used for treatment of other disorders such as deep brain stimulation for Parkinson’s disease and vagal nerve stimulation for epilepsy. SNS stimulates the sacral nerves to modulate the neural reflexes that influence the bladder sphincter and pelvic floor.
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