Overactive Bladder

If you’re experiencing the symptoms of common bladder control problems, it’s time to see a bladder incontinence specialist who may ask you to fill out a symptom tracker to get a better idea of your daily experience and help confirm your diagnosis.

Symptoms of overactive bladder (OAB) include:

Urge incontinence

• Urinating before you reach the bathroom
• Experiencing frequent leaks
• Using pads or protective garments

Urgency-frequency

• Frequent, uncontrollable urge to go
• Going more than 8 times a day
• Feeling like your bladder is never empty

Symptoms of urinary retention* include:

• Can’t tell if your bladder is full
• Holding increasingly large amounts of urine
• Weak or dribbling stream
• Needing to use a catheter

* Medtronic Bladder Control Therapies do not treat obstructive urinary retention.

Urinary retention is defined as the inability to completely or partially empty the bladder. You may be unable to start urination, or if you are able to start, you can’t fully empty your bladder.

Does This Sound Familiar?

• Difficulty starting to urinate
• Difficulty fully emptying the bladder
• Weak dribble or stream of urine
• Loss of small amounts of urine during the day
• Inability to feel when bladder is full
• Increased abdominal pressure
• Lack of urge to urinate
• Strained efforts to push urine out of the bladder
• Frequent urination
• Nocturia (waking up more than two times at night to urinate)

Why Is This Happening?

There are two general types of urinary retention: obstructive and non-obstructive. If there is an obstruction (for example, kidney stones), urine cannot flow freely through the urinary tract. Non-obstructive causes include a weak bladder muscle and nerve problems that interfere with signals between the brain and the bladder. If the nerves aren’t working properly, the brain may not get the message that the bladder is full.

Some of the most common causes of non-obstructive urinary retention are:

• Stroke
• Vaginal childbirth
• Pelvic injury or trauma
• Impaired muscle or nerve function due to medication or anesthesia
• Accidents that injure the brain or spinal cord

Obstructive retention may result from:

• Cancer
• Kidney or bladder stones
• Enlarged prostate (BPH) in men

Please note: InterStim™ is not indicated for Obstructive Retention 

Treat Yourself to Less Worry

Urinary retention is a treatable condition. Don’t be afraid to speak up about your symptoms and how they affect your daily life. This will help your doctor find the right treatment for you.

There are many ways to manage bladder control problems. Remember, if conservative treatments don’t deliver the results you need, you have more options.

Lifestyle Changes¹

Conservative treatments can help some people but may not work very well (or at all) for others. All of these are relatively simple behavioral changes that you may already be doing.

• Diet and exercise: Changes may include decreasing your caffeine intake and getting more exercise.
• Bladder retraining: Also called biofeedback, this involves delaying going to the bathroom and sticking to a strict schedule.
• Pelvic floor strengthening: This can be accomplished through Kegel exercises, which involve repeatedly contracting and relaxing the muscles of the pelvic floor.

Oral Medications

When lifestyle changes fail to deliver the results you want, oral medications are the next step. These medications can help control symptoms but may cause other issues.

You have to remember to take these medications every day. Some side effects can be unpleasant, such as dry mouth, blurry vision, constipation, and hypertension.² Other side effects are more serious. In fact, data suggests that one class of drugs for OAB (anticholinergics) may increase risk of dementia in elderly people.³ Even more important, these medications don’t always work. In one survey, 72% of people said they stopped taking their medication after just six months.⁴

Advanced Therapies

If conservative treatments don’t deliver the results you want, you have more options.

Medtronic Bladder Control Therapy Delivered by The InterStim™ System

• Try it during an evaluation
• Proven long-term relief⁵

Implanting an InterStim™ system has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection. Talk with your doctor about ways to minimize these risks. Complications can occur with the evaluation, including movement of the wire, technical problems with the device, and some temporary pain. Your doctor or nurse will provide you with the information regarding how to operate the test device and inform you of other precautions related to the evaluation and activity restrictions.

Learn More About Medtronic Bladder Control Therapy Delivered by the InterStim System

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

Important Safety Information

*Medtronic Bladder Control Therapies do not treat obstructive urinary retention.

1. American Urological Association. Diagnosis and treatment of non-neurogenic overactive bladder (OAB) in adults: an AUA/SUFU guideline. www.auanet.org/guidelines/overactive-bladder-(oab)-guideline. Accessed August 5, 2020. 
2. Haab F, Castro‐Diaz D. (2005), Persistence with antimuscarinic therapy in patients with overactive bladder. Int J Clin Prac, 59: 931-937.
3. Gray S, Anderson M, Dublin S et al. Cumulative use of strong anticholinergics and incident dementia. JAMA Intern Med. 2015;175(3):401-407.
4. Yeaw J, Benner J, Walt JG et al. Comparing adherence and persistence across 6 chronic medication classes. J Manag Care Pharm. 2009:15(9): 724-736.
5. Siegel S, Noblett K, Mangel J, et al. Five year follow-up results of a prospective, multicenter study in overactive bladder subjects treated with sacral neuromodulation. 2018; 199(1), 229-236.

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^6,7

• 84% satisfaction among those who use it⁸
• 3X greater improvements in OAB quality of life⁹
• 82% of people achieved success^† at 5 years⁶
• 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^6,7
• 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

Complications can occur with the evaluation, including movement of the wire, technical problems with the device, and some temporary pain. Your doctor or nurse will show you how to use the system and inform you of any activity restrictions and other precautions related to the evaluation.

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 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.

1. Dasgupta R. Critchley HD, Dolan RJ, Fowler CJ. Changes in brain activity following sacral neuromodulation for urinary retention. J Urol. 2005; 174:2268-2272

2. Griffiths D, Derbyshire S, Stenger A, Resnick N. Brain control of normal and overactive bladder. J Urol. 2005; 174:1862-1867.

3. Griffiths D, Tadic SD. Bladder control, urgency, and urge incontinence: evidence from functional brain imaging. Neurourol Urodyn. 2008;27(6):466-474.

4. Kenefick NJ, Emmanuel A, Nicholls RJ. Effect of sacral nerve stimulation on autonomic nerve function. British Journal of Surgery. 2003;90:1256-1260.

5. Patton V, Wiklendt L, Arkwright JW, Lubowski DZ, Dinning PG. The effect of sacral nerve stimulation on distal colonic motility in patients with fecal incontinence. Br J Surg. 2013;100:959-968.

6. Siegel S, Noblett K, Mangel J, et al. Five-year follow-up results of a prospective, multicenter study of patients with overactive bladder treated with sacral neuromodulation. J Urol. 2018; 199(1), 229-236. 

7. Medtronic InterStim Therapy Clinical Summary (2018).

8. Foster RT Sr, Anoia EJ, Webster GD, Amundsen CL. In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction. Neurourol Urodyn. 2007; 26:213-217.

9. Siegel S, Noblett K, Mangel J, et al. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim® Therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn. 2015; 34:224-230. 

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.

Bladder Symptom Diary

Record your symptoms to help your doctor understand your condition.

Care Pathway for Bladder Control

Understand all of your treatment options for dealing with bladder control issues.

Doctor Discussion Guide

Starting the conversation can be hard. This guide can help you talk to your doctor.

Medtronic Bladder Control Therapies

Understand your options and decide if a Medtronic Bladder Control Therapy is right for you.

Patient Therapy Guide – iCon™ Programmer (.pdf)

A handy guide to living with Medtronic Bladder Control Therapy delivered by the InterStim system, and to using your hand-held Medtronic iCon programmer.

Patient Therapy Guide – Smart Programmer (.pdf)

A handy guide to living with Medtronic Bladder Control Therapy delivered by the InterStim system, and to using your Samsung Smart Programmer device.