Urology

1. Urgency:  A sudden and overwhelming need to urinate immediately.
2. Frequency: Urinating more than 8 times a day (normal is about 4-6 times daily or every 3-5 hours)
3. Urge incontinence: Urine leakage (wetting accident) that follows a sudden urge (amount can be anywhere from a few drops to the entire contents of bladder)
4. Nocturia: Waking up 2 or more times during the night to urinate (most people can sleep 6-8 hours without having to urinate)

Overactive bladder is not a normal condition at any age. Without treatment, symptoms may go from merely bothersome to becoming a severe urinary bladder condition. When uncontrollable urgency, frequency or leakage become a troublesome pattern, it’s time to talk to your healthcare provider about this issue.

Bladder control problems affect tens of millions of people every day. If you’re one of them, you should speak up.

Does this sound familiar?

– Urinating more than 8 times a day
– Avoiding social events
– Using pads to control leaks

OAB Facts

– OAB is extremely common.
– 1 in 6 adults has OAB, or 43 million adults in the U.S.
– 4.5 out of 10 adults don’t seek help for overactive bladder

You Are Not Alone – Find Relief for Bladder Control Problems

Overactive bladder (OAB) is a treatable condition. It’s not a normal part of aging. And you shouldn’t have to deal with it on your own.

Do you qualify? Take a two-minute quiz to see if you qualify for treatment

Take the quiz

Medtronic Bladder Control Therapy Delivered by The InterStim^TM Systems

Evidence suggests that breakdowns in the bladder-brain communication pathway may be a root cause of OAB and non-obstructive urinary retention.^1,2,3 That’s why conventional treatments may not produce the results you want – they don’t directly target this miscommunication. Unlike conventional treatments, the Medtronic InterStim systems gently stimulate the sacral nerves in the pelvic area that control the bladder.^4,5 This may help restore* bladder-brain communication and reduce symptoms.

Get more control with the InterStim Systems

– 84% satisfaction among those who use it
– 3X greater improvements in OAB quality of life
– 82% of people achieved success† at 5 years
– Only therapy that lets you see if it works before you and your doctor decide
– More than 375,000 people worldwide have chosen the Medtronic InterStim systems for more control and long-lasting relief
– Recharge-free and rechargeable options let you choose the right device for your lifestyle

In addition to risks related to surgery, complications can include pain at the implant sites, new pain, infection, lead (thin wire) movement/migration, device problems, undesirable changes in urinary or bowel function, and uncomfortable stimulation (sometimes described as a jolting or shocking feeling). Talk with your doctor about ways to minimize these risks.

Is InterStim Right for You?

You may be a good candidate for Medtronic Bladder Control Therapy delivered by the InterStim systems if:

– You have significant OAB symptoms or non-obstructive urinary retention
– You’ve tried lifestyle changes and oral medications
– These therapies haven’t given you the relief you want

Say yes to the test

Take back control with an evaluation for an InterStim system

Unlike other bladder control treatments, this therapy lets you try it first with an evaluation – like a test run, not a long-term commitment.

Here’s how it works:

– The simple test starts at your doctor’s office or an outpatient center.
– A lead (thin wire) is inserted in the upper part of your buttock. The lead attaches to a small external device worn discreetly under your clothes.
– Stop, start, or adjust the therapy settings, with an easy-to-use programmer that resembles a smartphone.
– Go about most of your regular activities for 3 to 14 days
– Track your symptoms to see if they improve

Get more personalized treatment options

After your test, talk to your doctor about the results. Together, you can choose a powerful and personalized solution for your long-term care. Your evaluation device can be replaced with an implantable device called a neurostimulator during a short, outpatient procedure.

Bladder control therapy has risks similar to any surgical procedure. The most common adverse events experienced during clinical studies include pain at implant sites, new pain, lead migration, infection, technical or device problems, adverse change in bowel or voiding function, and undesirable stimulation or sensations. Any of these may require additional surgery or cause return of symptoms. Discuss these potential risks and benefits with your doctor.

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More control starts with our smart programmer

The smart programmer allows you and your healthcare provider to manage your therapy as needed. Unlike previous iterations of our technology that resembled a key fob without a display screen, our Smart Programmer allows you:

– Visibility to check your stimulation level on a clear, easy-to-read screen
– Adjust your stimulation with confidence that its been changed to the setting you intended
– Turn stimulation on or off
– Change therapy programs (as directed by your healthcare provider)
– Activate MRI mode and check MRI eligibility (see more information below)

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MRI Confidence

Medtronic’s proprietary SureScan™ MRI technology is what enables patients to get full-body^‡ 1.5 and 3T MRI scans. It is the only sacral neuromodulation system with this SureScan technology. This means:

– Full-body^‡ 1.5 and 3T MRI scans
– No impedance checks required prior to MRI scans
– Scans allowed even if you have had out-of-range impedances
– MRI mode is easy to activate or deactivate on Medtronic’s smart programmer without clinician or Medtronic interaction
– Digital display for clear confirmation of MRI mode activation

Access the Medtronic InterStim MRI Brochure to learn about our MRI Center of Excellence and MRI testing lab and for information on how to activate MRI mode on your smart programmer.

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*Restored function defined as a 50% or greater reduction in dysfunctional voiding symptoms from baseline

Numbers reflect completers analysis defined as patients with diary data at baseline and 12 months (n=220). Clinical success was 82% at 12 months using the modified completers analysis (subjects who either had a baseline and 12-month evaluation or withdrew early due to device-related reasons and are considered failures). Success defined as a 50% or greater reduction in your troublesome bladder symptoms.

Under certain conditions; see approved labeling for details. Patients with InterStim™ SureScan™ MRI Leads only.

Frequently Asked Questions

Why is this therapy different?
You can try it before you decide, and it’s reversible if you change your mind later. And unlike injections, it doesn’t require self-catheterization or repeated treatment visits.

What can this therapy do for me?
It may significantly reduce symptoms in people who have frequent urges to urinate or related frequent leaks or are unable to fully empty their bladder.¹

Will it cure my condition?
No. It can be effective, but it’s not a cure. If the neurostimulator is turned off or removed, symptoms can return.

What does the stimulation feel like?
Most people describe the stimulation sensation as a tingling, flutter, or vibration in the pelvic area. It should not be painful. Stimulation settings can be adjusted, and sensations will vary from person to person.

Can I have an MRI?
People with an InterStim™ system can have a full-body^‡ MRI scan under certain conditions. Your doctor will determine whether you meet those conditions.

Will insurance cover the costs?
Medicare and many private insurance companies cover this therapy. Talk to your doctor to learn more about your insurance coverage.

What is BPH?

Benign Prostatic Hyperplasia, or BPH, is a common condition in which the prostate enlarges as men get older. While BPH is a benign condition and
unrelated to prostate cancer, it can greatly affect a man’s quality of life. As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms. If left untreated, BPH can lead to permanent bladder damage.

Symptoms include:
– Frequent need to urinate both day and night
– Weak or slow urinary stream
– A sense that you cannot completely empty your bladder
– Difficulty or delay in starting urination
– Urgent feeling of needing to urinate
– A urinary stream that stops and starts

If you suffer from the above symptoms, you are not alone. BPH is the leading reason men visit a urologist.
You can measure your BPH symptoms by taking the International Prostate Symptom Score (IPSS) questionnaire.

What is the UroLift System? 

The UroLift® System is a minimally invasive, safe and effective procedure to treat an enlarged prostate providing rapid symptom relief and recovery of BPH symptoms. It is a proven
option for patients looking for an alternative to medications or major surgery. The UroLift® System is the only leading BPH procedure shown to not cause new and lasting sexual dysfunction.

How Does The UroLift® System Work?

The UroLift® System uses a revolutionary approach to treating BPH that lifts and holds the enlarged prostate tissue so it no longer blocks the urethra. It is the only available BPH treatment performed by a urologist that does not require heating, cutting, or removal of the prostate tissue. The procedure is typically performed using local anesthesia in a the physician’s office or ambulatory surgery center. Patients typically return home the same day without a catheter.

Frequently Asked Questions

Who is a good candidate for the UroLift® System treatment? You may be a good candidate if you are a male, 45 years of age or older, and have symptoms relating to BPH. Speak with your urologist to see if the UroLift® System treatment is right for you. If you have a known allergy to nickel, titanium or stainless steel, talk to your doctor about your allergy before getting a UroLift System treatment.

What should I expect during the treatment? Is it painful? How long does it take? If you and your doctor decide that the UroLift® System treatment is right for you, your doctor will provide you with more detailed information relating to the treatment. In general, the UroLift System is a minimally invasive treatment that entails minimal downtime. Your doctor will use the UroLift Delivery Device to deploy permanent implants to relieve obstruction caused by the enlarged prostate that is pressing on your urethra. The procedure, which usually takes about an hour, may be performed under local or general anesthesia and you may be given medication to feel comfortable during the treatment. This typically helps minimize discomfort during the procedure, though everyone’s definition for pain and discomfort varies greatly. Typically, no catheter and no overnight stay is required post-treatment.

What happens post-treatment, during the recovery period? Are meds required? After the treatment, patients typically go home the same day without a catheter. There is minimal downtime posttreatment and many patients experience symptom relief in as early as 2 weeks. Patients may experience some urinary discomfort during the recovery period. Most common side effects are mild to moderate and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge. Most symptoms resolved within two to four weeks after the procedure.

Does the treatment affect my sexual function? Clinical studies have shown the UroLift® System treatment does not cause new, sustained instances of erectile or ejaculatory dysfunction. The same cannot always be said of other BPH therapies such as TURP, laser, and even medication.

Does my insurance cover the treatment? The UroLift® System treatment is covered by Medicare and all major private insurers. Contact your insurance provider for your specific coverage information.

An enlarged prostate can mean frequent trips to the bathroom and include interrupted sleep causing quality of life to be less than optimal. Turn to Riverwood Healthcare Center’s expert Urologist for the latest and most innovative treatment options for benign prostatic hyperplasia (BPH) getting you back to a higher quality of life. The HoLEP treatment for urinary obstruction due to BPH and the Greenlight Laser Therapy are advanced treatment options.

Holmium Laser Enucleation of the Prostate (HoLEP)

What is holmium laser enucleation of the prostate (HoLEP)?

Holmium laser enucleation of the prostate (HoLEP) is a type of laser surgery used to treat obstruction (blockage) of urine flow as a result of BPH. In men with BPH, the prostate gland is not cancerous but has become enlarged. An enlarged prostate can result in a number of urinary tract symptoms such as frequent urination, inability to urinate, difficulty in starting urination, or loss of bladder control.

HoLEP was developed in the 1990s as a more effective and potentially less costly surgery for urinary obstruction due to BPH, as compared to other surgical options such as laser vaporization and transurethral resection of the prostate.

How does holmium laser enucleation of the prostate (HoLEP) work?

The holmium laser is a surgical laser that has been found particularly effective in performing several types of urological surgeries. In the case of HoLEP, the laser is used to cut and remove the bulky prostate tissue that is blocking the flow of urine.

Who needs to have holmium laser enucleation of the prostate (HoLEP)?

BPH occurs in more than 40 percent of men over the age of 60 and is a leading cause of urination symptoms, including difficulty in passing urine. As men age, the symptoms of this condition can worsen. Although many cases of urinary obstruction from BPH can be treated without surgery, patients who do not benefit from such medical treatments may eventually need surgery to avoid or deal with long-term problems such as retention of urine, urinary tract infections, and gallstones.  Patients who are appropriate for HoLEP are typically symptomatic due to very large prostates.

Patients may not be candidates for HoLEP if:

– They have bleeding problems.
– They have had certain types of prior prostate treatments.
– They cannot lie on their back with their legs raised. This position is necessary for the procedure.

GreenLight™Laser Therapy

This treatment option provides rapid relief of symptoms caused by benign prostatic hyperplasia (BPH). In many cases, GreenLight™ Laser Therapy also offers a shorter hospital stay, less catheterization time, less bleeding, and a faster recovery than traditional surgical options.

Who is this for

GreenLight is suitable for most patients with an enlarged prostate. One of the benefits of GreenLight is the speed in which the treatment works. Most patients return home a few short hours after the procedure and can return to normal, non-strenuous activities within days.

How it works

During the procedure, your doctor uses a laser to rapidly heat and vaporize the excess prostate tissue, resulting in a larger channel for urine to pass through. Removing the excess tissue rapidly restores natural urine flow in most patients.

The procedure

The GreenLight laser procedure is typically performed on an outpatient and inpatient basis under general anesthesia. Most patients experience rapid relief of BPH symptoms and improvement in urine flow after the procedure. Your doctor can tell you more about the surgical procedure.

Not necessarily, although urinary incontinence occurs about twice as often in females than males. Pregnancy, childbirth, menopause and female anatomy account for the difference. But of the approximately 12 million sufferers in the United States, about one-third are men. Male incontinence is often associated with prostate problems or treatments.

Generally, it’s a good idea to call your doctor or schedule an appointment if you have a sudden onset of incontinence, if you’re having enough accidents that you need to either wear a pad for urine absorption, or if incontinence is interfering with your lifestyle.

A change in the normal balance of water salts, mineral and other components in urine creates a process known as urolithiasis in which solid mineral particles cluster in the kidneys. There are different types of stones, including calcium oxalate, uric acid, ammonic magnesium and cystine.

Certain groups of people are more prone to kidney stones, and some medical conditions can be contributors. Men in their 30s, 40s and 50s are mostly likely to get stones, and postmenopausal women and women who have had their ovaries removed are at a higher risk than normal. Other contributors include frequent urinary tract infections, insulin resistance, cystic fibrosis, gout, inflammatory bowel disease, gastric bypass surgery, hyperparathyroidism, high blood pressure, and bladder problems resulting from spinal injuries.

Drink lots of water. The most common cause of stones is an insufficient daily water intake. The goal should be to drink enough to keep your urine clear – about eight to ten glasses per day. In addition, studies have indicated that staying physically fit and keeping your weight in check can help as well.

The no-scalpel incision vasectomy has become very popular in the U.S. because of the decreased discomfort that men experience with this particular technique. We perform the no-scalpel incision vasectomy and would be happy to provide you with more information about this procedure.

The American Cancer Society recommends annual screening for all men over the age of 50, including a digital rectal exam and a PSA (prostate-specific antigen) blood test. Men with a family history of prostate cancer should start annual screenings between age 40 and 45.

One reason that screening for prostate cancer is so important as a man ages is that localized and curable prostate cancer has no symptoms. A decrease in the force of the urinary stream or other voiding issues is most likely due to benign prostatic hyperplasia (BPH) than prostate cancer. For men with localized prostate cancer and some urination problems, the explanation is that BPH is occurring coincidentally with the prostate cancer. Men with advanced prostate cancer, however, may have similar symptoms as men with BPH, including blood in the urine, painful urination, and a decreased urinary flow. Fortunately, with today’s emphasis on screening and early detection, more than nine in 10 prostate cancers are found in potentially curable stages.