The Basics of Neuromodulation

By Paul J. Watkins

If you're a woman experiencing little bladder leaks, you may have tried many different things to control your symptoms. You may have cut back on drinking coffee and tea, because they can irritate your bladder and cause leakage. Or maybe you've reduced the overall amount of fluids you drink. If you’re a smoker, you may have tried to quit because you know nicotine can also irritate your bladder. Perhaps you've avoided the activities and social situations that lead to little leaks. You may have tried different medications prescribed by your doctor, but have not seen much improvement. Bottomline, if you’re still looking to avoid surgery, neuromodulation may be an option for you.

"Neuromodulation is a process whereby a device is used to stimulate the nerves or the distribution of nerves which control bladder function," says Chester C. Wilmot, MD, a urologist with the Florida Urological Institute in St. Petersburg, Florida "The goal of neuromodulation is to restore normal bladder function.”

Wilmot continues, “Neuromodulation is currently used in three instances: people who have a sense of urinary frequency and urgency who have failed medical therapy, individuals who have urge incontinence that have failed medical therapy, and people who have evidence of urinary retention with no mechanical, identifiable cause for obstruction—what we call non-obstructive urinary retention.”

He adds, "stimulators can be applied to the tibial nerve in your lower leg—and that stimulation has been shown to be effective in controlling bladder symptoms."

One device used is called the Urgent® PC Neuromodulation System and is a non-surgical treatment done in your doctor's office which takes about 45 minutes. The treatment is usually given once a week for ten weeks.

The InterStim® neurostimulator is another form of sacral neuromodulation, and placement involves a testing phase and an implant phase. Dr. Wilmot continues, "The mechanism by which the stimulators work is not entirely understood. It appears to reinforce neural connections, and it tends to decrease the excitation that occurs when people have this sense of frequency and urgency."

No treatment for urinary incontinence works for everyone, and tibial nerve stimulation with the Urgent® PC Neuromodulation System is no exception. However, Dr. Wilmot says response to InterStim® is also encouraging: "There's good evidence that women who fail conventional therapy, pass the test phase, and use a devices like these have long-term, proven benefit.

For more information about neuromodulation therapy consult your doctor or health care professional.

For more information about the Urgent® PC Neuromodulation System, visit www.uroplasty.com.

For more information about the InterStim® neurostimulator, visit www.medtronic.com.