Sacral neuromodulation, which is also called interstim, acts to provide a small amount of electrical stimulation to the nerves that run through the tailbone (sacrum) to the bladder. For reasons we do not well understand, this can improve or eliminate bladder overactivity and urinary leakage. Another application of this therapy is for patients that develop urinary retention and cannot urinate effectively. This therapy can be thought of as a bladder pacemaker. The electrical stimulation is usually not something that causes pain or discomfort.

University of Utah Health Care urologic specialists are experts in sacral neuromodulation. Call today to schedule a consultation and find out if interstim therapy is right for you.

Who does this therapy work for?

One of the best applications of this therapy is for women that have overactive bladder. In this condition with aging the bladder starts to give inappropriate signals to urinate and patients feel urgency and frequency of urination.

This is a condition that affects mostly aging women. When this condition is severe women will frequently have urinary leakage as a result of the bladder spasms. Another application of the therapy is in women that have a condition where their bladder stops working. This is referred to as Fowler’s syndrome. Often there is some precipitating factor like a recent unrelated surgery.

What are other applications of sacral neuromodulation?

There are some other conditions that can respond to the use of sacral neuromodulation:

Spinal Cord Injury: One of these conditions is found in patients with partial spinal cord injury. Usually a good measure of partial spinal cord injury, which might respond to sacral neuromodulation is a patient with greater than 50 percent motor function below their injury. For instance some patients can walk after a partial spinal cord injury. These patients may respond to sacral neuromodulation and eliminate bladder spasticity or urinary retention.

Multiple Sclerosis: Another potential application is patients with multiple sclerosis that have good lower extremity function and can walk well. In a similar way to partial spinal cord injured patients, the fact that these patients are ambulatory indicates that many of the spinal pathways that are needed for this therapy to work are intact.

How is sacral neuromodulation performed?

Sacral neuromodulation is an outpatient procedure that involves two operations about one to two weeks apart.

Operation 1: In the first operation patients are in a twilight sleep with anesthetics and lie on their stomachs in the operating room. The locations of the nerves to the bladder are found and electrodes are placed onto the nerve on both sides. The electrodes are internally connected to temporary small wires that come out of the side of the body. 

When the patient wakes up a temporary stimulator is connected to these wires. The patient then has the nerves stimulated for one to two weeks from this external unit. If the patient’s urinary problem is improved by 50 percent or resolved with the therapy than the permanent unit is placed.

Operation 2: In this second operation the permanent electrodes placed in the first operation are attached to a stimulator that is implanted above the buttock and hipbone. This unit will last three to seven years depending upon several factors, like how much stimulation is required. It can be changed, in the future, when the battery wears out in a small surgery without disturbing the permanent electrode in the nerve.

If the first surgery and the stimulation is not successful than in the second operation the electrodes are removed.

Inerstim Therapy for Bladder Control (pdf)

William O. Brant, M.D., FECSM, FACS

William O. Brant, M.D., FACS, is a board-certified urologist. He attended Dartmouth College and the University of Washington, Seattle and then obtained his medical degree at the University of California, San Diego, followed by residency at the University of Colorado. Dr. Brant pursued a fellowship in sexual medi... Read More

Specialties:

Erectile Dysfunction, General Urology, Male Incontinence, Men's Health, Trauma and Reconstructive Urology, Urology, Vasectomy

Locations:

South Jordan Health Center (801) 213-4500
University Hospital
Urology
(801) 213-2704
Utah Center for Reproductive Medicine

James M. Hotaling, M.D., M.S., FECSM

Dr. Hotaling has significant training in both the clinical aspects of male fertility and genetic epidemiology and he is currently the only fellowship trained male infertility/andrology expert in Utah. He completed a 6 year residency in urology at the University of Washington, elected to pursue a year of sub-sp... Read More

Jeremy B. Myers, M.D.

Dr. Myers completed specialty training with Dr. Jack McAninch at University of California, San Fransisco. His fellowship was in trauma and urologic reconstructive surgery. In his practice, Dr. Myers treats a variety of conditions. These include conditions like urethral strictures, ureteral scarring from previ... Read More

Specialties:

Bladder Augmentation, Complications of Spinal Cord Injury, Complications of Urologic Surgery, Female Incontinence, General Urology, Mesh Erosion, Neurogenic Bladder, Pelvic Fractures and Urethral Injury, Radiation Injuries, Trauma and Reconstructive Urology, Ureteral Stricture, Urethral Stricture, Urinary Diversion, Urinary Strictures and Fistula, Urology, Vesicovaginal Fistula

Locations:

University Hospital
Urology
(801) 213-2702

Kathryn M. Trueheart, PA-C, MPAS

Kathryn (Kate) Trueheart, PA-C, grew up in Rochester, New York and attended Boston University where she completed an undergraduate degree in East Asian studies. From there she went to Berkeley, California, where she attended Meiji College of Oriental Medicine, earned a master of science in Oriental medicine and ... Read More

Specialties:

Erectile Dysfunction, General Urology, Men's Health, Physician Assistant, Trauma and Reconstructive Urology, Urology

Locations:

Redstone Health Center (435) 658-9200
South Jordan Health Center (801) 213-4500
University Hospital
3rd Floor, Room 3A100
50 N Medical Drive
Salt Lake City, UT 84132
Map
Appointments
(801) 213-2700
Redstone Health Center 1743 W Redstone Center Dr. #115
Park City, UT 84098
Map
(435) 658-9262
South Jordan Health Center 5126 W. Daybreak Parkway
South Jordan, UT 84095
Map
(801) 213-4500