People who are not helped by overactive bladder medicines or who are not happy about having to be on the medicines for the rest of their lives may want to look into the interstim. It is also frequently the treatment of choice for people with bladder problems related to spinal or nerve damage or multiple sclerosis. 

The treatment begins with a voiding diary and cystometrogram to accurately diagnose the problem and to exclude stress incontinence, infection and other things. If the testing shows overactive bladder and drug therapy not a good alternative, then the patient may be  a candidate for Interstim.

The principle of Interstim therapy is that stimulation of the pudendal nerve interferes with the bladder reflexes. If these reflexes are defective and causing symptoms, the modifying the reflexes  may be curative. This principle is used in several different therapies including peroneal nerve stimulation, and Neocontrol. There is a conceptual relationship to acupuncture. 

The Interstim treatment consists of inserting a small wire  electrode into the opening in the sacrum where the bladder nerve passes.  The test electrode is inserted through a needle under local anesthesia, frequently in the office, sometimes in Same-day surgery. The electrode wire is connected to a temporary generator and the patient wears it for a few days. If the bladder symptoms improve, usually by about 50%,  then we will go to a permanent system. The permanent electrode is implanted in the sacrum in the operating room and a permanent generator, much like a pacemaker, is put  under the skin of the buttock. The generator lasts for anywhere from 4 to 9 years. Most people are aware of a "fluttery" or tingling sensation in the area of the bladder from the electrode stimulation. Complications are not common with the procedure, but it is possible to get infection around the device or to have bleeding or even nerve damage. These are rare. Somewhat more common is to have the effectiveness of the stimulation  decrease over time. Sometimes this can be corrected by moving the electrode to the other side of the sacrum. 

If you are having problems with overactive bladder and the medicines don't seem to help the Interstim may help. Check out the Medtronic web site or talk to your doctor. Medtronic maintains a list of doctors who are Interstim qualified . Most urogynecologists or urologists are familiar with the therapy.