Is InterStim sacral neurostimulation effective in treating incontinence?

In the late 1990s, the FDA approved a pacemaker-like implanted device, InterStim, for use in men and women with bladder overactivity that has not responded to medication, bladder training, or biofeedback. In a 152-person multicenter trial without a control group, sacral neuromodulation significantly improved symptoms of severe urgency and frequency. This study, published in The Journal of Urology, showed that after five years, 58% of patients sustained at least a 50% reduction in leaking episodes, and 68% experienced at least a 50% improvement in heavy leaks. Forty percent of the patients with urgency and frequency problems reduced their number of voids by at least half, and 56% had a 50% or greater improvement in urgency symptoms.

On the other hand, this treatment is not without risks. About one-third of patients require repeat surgery because of pain, infection, or movement of the wire. InterStim is expensive, but Medicare and most insurers cover it.

Sacral neuromodulation is now FDA approved for fecal incontinence.

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