Neuromodulation can reduce discomfort of an overactive bladder.
Certain conditions that affect the genitourinary system may require more extensive treatment than lifestyle changes or medication. In these cases, neuromodulation may be a good option. Neuromodulation, sometimes referred to as nerve stimulation, can be a way to reduce the urinary discomfort of an overactive bladder or the pain associated with a disorder in the pelvic region.
By stimulating a specific nerve or neural region, a specialist may be able to help the patient to be more comfortable with less interruption to daily life.
How it Works
There are several types of neuromodulation that can be tried, depending on the source of the problem. Nerve stimulation occurs by providing an electrical impulse to the affected nerve or nerve complex. Neuromodulation can help to regulate proper signaling between the brain and the nerves. This can also be used to assist the nerves that affect the muscles controlling functions in the genital region, the bladder, and the bowels. Pudendal neuromodulation is typically used to address pain in any of the systems located within the pelvic region, while sacral neuromodulation is generally used to address problems with the functioning of the bladder or the bowels. Neuromodulation treatment can refer to:
- An implanted device that automatically stimulates the appropriate nerve or nerve groups
- Weekly electrical stimulation to the nerve above the ankle that leads to the sacral nerves, called percutaneous tibial nerve stimulation
- OnabotulinumtoxinA injections
Who is a Candidate?
Those who turn to the possibility of neuromodulation are those who have a condition such as an overactive bladder, fecal incontinence, chronic pelvic pain, or other similar health issues. For these patients, neuromodulation may be a good option if treatment with medication was not successful or caused too many unwanted side effects. Patients should be in good physical health to receive the implanted device for nerve stimulation. Those who want a less invasive method than surgery may opt for injections of OnabotulinumtoxinA or the PTNS weekly treatments.
What to Expect
The least invasive of the neuromodulation methods listed is OnabotulinumtoxinA injections. For those with an overactive bladder, OnabotulinumtoxinA can block the nerve signals that lead to the bladder. This can lessen the sense of urgency for urination, allowing the individual to wait longer between trips to the bathroom. Effects of OnabotulinumtoxinA injections have been shown to last up to nine months.
Percutaneous tibial nerve stimulation can be used as a weekly treatment. For about three months, a patient will see the therapist for a half-hour session. A small electrode in the form of a needle is inserted beneath the skin just above the ankle. From there, the electrical impulses can provide the necessary stimulation to the sacral nerve to decrease activity of this nerve complex.
The surgical option involves the implantation of a device that leads to a wire with an electrode on the tip. This electrode can stimulate the sacral or pudendal nerve region to bring about the desired relief.