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Thread: Interstim Therapy

  1. #1
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    Interstim Therapy

    Has anyone tried this implant from Medtronic which provides electrical stimulation to the bladder? Eight months post my husband had a ten day test run with this device and could not wait to have the electrodes removed because his spasticity increased so much in his trunk area.(T4 incomplete) His urologist could not explain this reaction and I was unable to find anyone at Medtronic who knew if any other persons with SCI had tried this with similar results. Anyone had a similar reaction or success with this? Kathy

  2. #2

    Interstim Therapy

    I am not familiar with a system manufactured by Medtronic. I know they make the baclofen pump, spinal cord stimulator for pain controller, and deep brain stimulator but I did not know that they made one for bladder stimulation. I am familiar with the one manufactured by Neurocontrol called the VOCARE system.

    The company's literature states that "The VOCARE bladder system is an implanted medical device which has been used to empty the bladder on demand. A secondary benefit from the system us to aid in bowel evacuation". It is surgically implanted by a neurosurgeon. It has both implanted and external components. The system sends electrical signals through electrodes to the nerves that lead to the bladder or bowel. The person controls the implant with an external controller. The best candidates for this procedure are those with clinically complete SCI's who are neurologically stable and have intact reflex bladder contractions. The surgical procedure to implant this can take 6-12 hours and involves a surgical cutting of spinal nerve roots to prevent futher reflex incontinence and the placement of electrodes to an implantable receiver-stimulator under the skin of the abdomen. There are actually 4 incisions made to accomodate everything. It usually involves a 4-5 stay in the hospital following surgery. Possible complications are listed as device malfunction, lead breakage, spinal nerve root damage, infection, skin breakdown, continued post-operative incontinence, and/or temporary changes in lower limb reflexes. So far, patients who have had this performed report increased quality in their life. Our representative here is telling us that the best candidate is a female who finds it most difficult to self-cath and continues to have reflexive wetting between caths. To find out more about this system you can contact www.neurocontrol.com. PLG

  3. #3

    A critical review of the Interstim Device

    Here is a very critical review of the Interstim device. Judge for yourself. It contains links for many other sites.

    http://www.incontinet.com/empire4.htm

  4. #4

    Interstim therapy

    Wasn't familiar with the Medtronic system before as it is not being used here with our SCI population. You can check their site as well at http://www.medtronic.com/hic/bladder.html

    PLG

  5. #5
    The Interstim device was rally designed for people who need bladder stimulation and not necessary for spinal cord injured people for whom the stimulation would greatly increase spasticity. The Vocare system, in order to avoid the spasticity, requires the cutting of the sacral dorsal roots so that the stimulation does not activate the spinal cord. Cutting of the roots would be very difficult to reverse and therefore the Vocare system has not been as popular. However, there is some research that suggests that the stimulation can be modulated in such a way that it does not activate the spinal cord as much and thereby not require the cutting of the roots.

    Wise.

  6. #6

    Interstim Therapy

    Thank you Wise for the clarification. PLG

  7. #7
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    (Sigh), how I wish I had this information before we agreed to this test. I approached his Urologist about the Vocare System because I had read the glowing reviews of happy patients. He could not wait to do the surgery. Everything I had read indicated a simple outpatient procedure. We arrived at the University Hospital anticipating this only to be told that the surgeon had changed his mind and wanted my husband to be under general anesthesia with all the possible complications of AD. Medtronic had sent a representative to observe the surgery and "quickly advise" us how to use the device. Through the test period the urologist was unavailable for questions and concerns, though his nurse attempted to help. There was absolutely no follow up from Medtronic or his Urologist although we pursued both with questions and each referred us to the other. What a dissapointment this was. Kathy

  8. #8

    Exclamation Researching SCI and Interstim Therapy

    I am a 52 year old woman with a SCI of 34 years post, I am T12, L1, L3 incomplete. I am wheelchair bound.

    I looking for advice from anyone who has experience or knowledge with Interstim therapy on a SCI person.

    I am scheduled for surgery and need information as soon as possible.

    My main concern, of course is, will it work?

    My concerns are:
    -sitting and putting pressure on the site of implant, as well as, where the leads are.
    - breaking the implant due to falling, as I am quite active.

  9. #9
    Senior Member MikeC's Avatar
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    They had me test it for about 10 days before doing the implant. The test didn't work so no implant. Are they testing it on you before doing the implant? Mike
    T12 Incomplete - Walking with Crutches, Injured in Oct 2003

  10. #10
    Interstim does not give you voluntary control over urination. it MAY (and this is a big maybe) help reduce bladder spasm and leakage between intermittent catheterization. It is not used instead of intermittent cath, so does not make you void or urinate. I would never recommend this for someone who is not going to have a trial external stimulator implanted first, and who tries it that way for at least 2 weeks. It is really not indicated for those with SCI, esp. with complete injuries.

    (KLD)

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