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For two years, Sherry Miller, 43, a resident of Tuckerton, lived with the physical and emotional effects of an overactive bladder. Whether it was pregnancy, childbirth or a minor gynecological procedure that weakened her bladder, she’s unsure; but whatever the cause, this mother of two felt helpless and alone. Plagued with the constant urge to urinate and embarrassing leaks whenever she coughed or sneezed, Miller limited outings to quick trips to the grocery store – where she was all too familiar with the location of the bathroom.
“I really didn’t go out for my own enjoyment anymore. It was embarrassing,” she recalls, recounting her ordeal. “I would go to the bathroom, and within minutes feel the urge to go again.” Accidents at home were common and while frustrating – not as embarrassing as the leaking episodes that happened while she was at work. “I’d have to cross my legs or hold myself to try and keep from leaking,” she says. “It was a very embarrassing situation, and I couldn’t believe it was happening to me.” Miller’s situation is not unique and she’s far from alone.
Urinary incontinence – the inability to control the bladder – affects millions of Americans. And while both men and women can be affected, women are twice as likely to suffer with bladder control issues than men. According to the National Association for Continence (NAC), an estimated 13 million Americans are affected by urinary incontinence –– and more than half of those people are women.
“Pregnancy, childbirth and menopause often weaken the muscles that control bladder function, resulting in the higher incidence of incontinence found in women,” explains Mukaram Gazi, M.D., a board certified urologist on staff at Kimball Medical Center. “That’s not to say that incontinence is a normal part of aging in women – this is a common and unfortunate misconception that many women share,” he adds.
According to Dr. Gazi, incontinence is actually a symptom of an underlying problem with the muscles and nerves that control bladder function. Nonetheless, according to the NAC, only one out of every 12 individuals affected by this condition ever seeks treatment.
“The inability to control the bladder is a very personal and intimate issue that people are hesitant to discuss, even with their doctor. Many women – and men for that matter – are embarrassed by urinary incontinence and sometimes wait years before they’ll seek treatment,” he explains.
While there are a variety of different therapies to treat incontinence including exercise, medications and surgery, a minimally invasive procedure now available at Kimball Medical Center is offering new hope for those who suffer from incontinence.
“The procedure is known as Sacral Nerve Stimulation with InterStim,” explains Dr. Gazi. “It uses mild electrical pulses to stimulate the sacral nerves which are located in the lower back, just above the tailbone.” These nerves, according to Dr. Gazi influence the behavior of the bladder, sphincter and pelvic floor muscles, all of which contribute to bladder control.
“The technology,” explains Dr. Mukaram Gazi, “is similar to a pacemaker for the bladder. Just like a pacemaker programs the heart to beat a certain way, the InterStim Therapy sends electrical impulses to the bladder to reprogram the way it performs,” he explains.
The InterStim procedure, which can be helpful to both women and men, was approved by the Food and Drug Administration (FDA) in 1997. In 2002, the FDA approved a new, minimally invasive version of InterStim, which requires only a small skin puncture under local anesthesia. The procedure is covered by Medicare and by many health insurance plans. The best candidates for this procedure, according to Dr. Gazi, are – like Sherry Miller – those patients who experience urinary frequency or an overactive bladder.
“We follow a strict protocol,” he explains, “to ensure the best results for our patients with the least invasive approach,” says Dr. Gazi, noting that surgery, even the minimally-invasive kind, is not the first course of therapy for incontinence. “Medications are often successful at helping his patients with incontinence issues, so we try those first. For those who are not helped by medication, or who find the side effects intolerable, InterStim therapy could be the answer,” he says.
The procedure is completed in two parts to ensure success. Initially, patients have a small wire inserted under the upper part of the buttocks (the sacral nerve is located adjacent to the tailbone) that is attached to a temporary test stimulator. Patients wear the device for approximately a week and keep a ‘bladder record,’ a log of when they urinate.
After the test period, the patient’s log and overall success of the InterStim technology in regulating the bladder is evaluated and the test stimulator is removed. “Usually, at this time, patients are so happy with the results that they don’t want the device removed,” says Dr. Gazi – which is precisely what happened in Sherry Miller’s case.
“We tried other options for Sherry,” explains the doctor, “including overactive bladder medications, but they didn’t help. The InterStim test stimulator worked really well for her and she’s a perfect candidate for this procedure.” Miller whole-heartedly agrees.
“During the test period I had no accidents,” she says. “When I went to the bathroom, that was it, I didn’t have to go again a few minutes later. It was amazing,” she adds.
Once the test stimulator has demonstrated success for the patient, a small pacemaker-like battery is then permanently implanted under the skin and attached to the wire for long-term control. The procedure is minimally invasive and completed under local anesthesia and mild sedation. After the stimulator is implanted, the patient receives a remote control that allows them to adjust the strength of the electrical pulse – if they need to.
“I am really looking forward to having the permanent implant. I’ll be able to cough and sneeze all I want without having to worry about leaks,” she jokes, “and I’ll be able to go out and enjoy myself again!”
The InterStim Therapy can dramatically reduce, and in many cases eliminate overactive bladder symptoms altogether, with minimal or no side effects, according to Dr. Gazi. “Patients are so happy with the results of this procedure – and grateful to have their quality of life back.”
In addition to helping patients like Miller with urinary incontinence, Dr. Gazi is hoping to expand the application of the InterStim technology at Kimball Medical Center to patients with multiple sclerosis, helping patients manage urinary incontinence and bladder dysfunction which are common symptoms of this progressive and debilitating disease.
If you or someone you know suffers from urinary incontinence, find out whether you might be a candidate for the InterStim Therapy procedure now available at Kimball Medical Center. For more information about the procedure or for a referral to a Urologist on staff at Kimball Medical Center, call 1-888-SBHS-123.
CONTACT: Kristine A. Brown
Director of Public Relations
(732) 557-3902
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