What to Do If OAB Medications Don’t Work

November 3, 2022

Having a diagnosis of an Overactive Bladder (OAB) can be frustrating. Especially if first-line therapies don’t work. For many people, physical therapy, lifestyle modifications, and medications may be enough to control overactive bladder symptoms.

But sometimes, those things simply don’t work, or they don’t provide enough relief to restore your quality of life. Mediations may also cause unwanted side effects, so they may not be the best choice. Fortunately, there are other options if OAB medications don’t work.

What to Do If OAB Medications Don’t Work

One of the best treatments for OAB that doesn’t respond well to medications is neuromodulation. This may be done as an outpatient procedure at a doctor’s office with percutaneous tibial nerve stimulation (PTNS). A small needle is placed into a nerve at the bottom of the leg and is electrostimulated. The tibial nerve in your leg is connected to bladder nerves and this treatment helps to regulate the bladder nerves.

For those that need a more permanent solution, electrostimulation of the nerves with an implantable device may be the best option.

The Medtronic InterStim System

The Medtronic InterStim System for urine control is intended to treat OAB or urge incontinence in people who could not tolerate or did not respond to more conservative treatments.

InterStim therapy is a reversible treatment that employs an implantable device to provide mild electrical pulses to a lower back nerve. This nerve, known as the sacral nerve, affects the bladder, intestines, and surrounding muscles that regulate urinary and bowel function. Abnormal bladder contractions cause OAB. When these contractions are interrupted by the InterStim neuromodulator, bladder control issues may be relieved.

InterStim Testing Phase

There is a trial period before implanting the InterStim device. Doctors conduct the test phase procedure in an operating room or a medical office. The doctor will numb a small region near the tailbone before inserting a thin, flexible needle. This needle will be connected to a wire close to the sacral nerves.

A small amount of electrical stimulation will be used to determine the optimal placement by testing the sensations you experience.

Once the doctor has determined the best location, the temporary testing wire will be linked to an external battery that can be worn on a belt. You’ll have a remote to control the stimulation intensity, allowing you to customize the device to your specific needs.

The testing phase will last between one and three weeks. During this period, the doctor will request that you keep a bladder diary to track your daily urinary habits.

InterStim Permanent Placement

If there is an improvement in urinary symptoms and you are happy with your results so far, the permanent battery will be implanted. The battery, which is similar to a pacemaker, is surgically placed in the upper buttock.

Recovery takes place at home. During the first 7 to 10 days, you’ll limit activity so your body can stabilize the device’s positioning. This helps decreased complications such as pain and infection at the implant site.

InterStim won’t damage nerves and may be removed or easily turned off at any time. With a remote control allocated to your device, you have complete control over your incontinence treatment. Studies have demonstrated reductions in urine urgency and frequency and an overall improvement in individuals’ quality of life.

Don’t continue to live with OAB that isn’t responding to medications – schedule an appointment today!

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