Many people are suffering from embarrassing problems related bladder control. The body’s drainage system that removes urine composed of wastes and extra fluid is known as the urinary tract. Other parts of urinary tract are kidneys which are in pair located just below the rib cage, ureters, thin tubes of muscle which carry urine from each kidney to the bladder, and bladder located in the pelvis bone, a hollow muscular, balloon shaped organ which can expands when filled with urine. All these parts of the urinary tract need to work together in the correct order for normal urination to occur. It can be slightly bothersome as for some people; the chance of embarrassment keeps them away from enjoying many activities like exercising, cycling, dancing etc causing more emotional distress. A person may feel trapped by fear of leaking accidents and may need to be close to a bathroom at all times. Most of the bladder control problems can be treated with less invasive treatments such as diet changes, exercises, medication etc. External collection devices like catheters or absorbent undergarments may be used when these minimally invasive treatments does not work or in severe cases, may also consider surgery. When conservative treatments do not work well, doctor may recommend other therapy like interstim therapy or Botox therapy for Urinary Control problems that may provide relief from symptoms.
Some signs and symptoms of overactive bladder or bladder control problems that may include:
• Urgency Frequency - Sudden and frequent urges to urinate
• Urge Incontinence - Inability to hold urine or urine leakage
• Complete Urinary Retention – inability to urinate
• Partial urinary Retention – incomplete bladder emptying
InterStim therapy is used for the treatment of urinary retention and over-active bladder including urge incontinence, non-obstructive urinary retention, and symptoms of urgency in patients who has failed to respond to more conservative treatments. This therapy involves a small implanted medical device placed under the skin in the hip area to send mild electrical impulses to the sacral nerves which control the bladder and surrounding muscles that manage urinary function. The electrical stimulation may eliminate or reduce certain bladder control symptoms in some people offering relief to patients. This stimulator generally runs for 8-10 years and can be replaced during an outpatient procedure. InterStim Therapy is reversible — it can be programmed off at any time.
Other type of treatment to manage over-active bladder is Botox which is given to calm the nerves and muscles around the bladder for which anticholinergic drugs didn’t work well.
This procedure can be done as outpatient and patient is asked not to eat or drink at least 5 hours before the procedure. Doctor will inject the Botox into the bladder muscle under the influence of general anesthesia. The bladder is emptied afterwards. The effects of a Botox injection can last for up to eight – nine months.
A patient may notice a reduction in the urgency and frequency of passing urine about 5 days after the Botox injection has been given. Blood can be seen sometimes in the urine after Botox injections, as a needle penetrates the bladder wall. The blood may appear for a few days, but always wears off after a while. An infection may develop in the urine, but antibiotics are given to avoid this.
There are also some side effects of the Botox therapy that may include:
• Allergic reaction
• Urinary tract infections