As per the new Cochrane Library review, an electrical device is helpful in patients with bladder disorders of holding urine. The implant is battery operated with two electrodes implanted beneath the skin, exactly near the sacrum or "tailbone" , meant for giving continuous shock to the nerves controlling the bladder in the form of uninterrupted tapping sensation in the pelvic area.
"There are few treatments that can claim to cure people with overactive bladders or urinary retention," said lead author G. Peter Herbison, from the Dunedin School of Medicine in New Zealand. "It is possible that implanted pulse generators will do just that."
"Depending on how it is defined, around 17 million people in the U.S. may have bladder control problems," said Kenneth Peters, M.D., chairman of urology at Beaumont Hospital in Royal Oak, Mich.
There are varied responses by different people for different treatments like medications,behavioral therapy or other noninvasive means , while surgery being the only option for those with stress incontinence.
Herbison and his co-author studied the effect of this implant on patients with urine storage problems, who had not responded to other less invasive treatments and he found the results were very beneficial for patients with overactive bladder and with no known obstruction.
The review has been published in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all spheres of health care.
"For those who have tried all nonsurgical approaches including bladder retraining, physiotherapy for the pelvic floor muscles and medications yet the symptoms persist, it is worth discussing this option with your primary care doctor, who may refer you on to a urologist," said review co-author Dr. Edwin Arnold, at the department of urology at Christchurch Hospital, in New Zealand. "This treatment is not for everyone and even if the operation is undertaken, it does not always work, so a patient's expectations should remain realistic."
The implant treatment method is not suitable for all the patients identified with the problem as 30 percent of them may not be the right candidate and may not receive the implant and another 30 percent of those who receive it, may not benefit from it over the period of time.
There are two major groups of people benefitting from the said procedure.
"Patients who might be considered are those in whom all nonsurgical approaches have been tried and whose symptoms remain bothersome and persistent," Arnold said. "This includes those who have increased daytime frequency of passing urine, who need to rise at night to empty the bladder and associated urgency with or without urge incontinence."
The second category of patients is uncommon and they are the ones who are unable to empty the bladder and yet have no mechanical obstruction.
"This report supports the technology of neurostimulation, which has been literally life changing for many of my patients," Peters said. "There is now very solid evidence that the procedure is useful, safe, reversible and should be an option in the treatment of more patients with these concerns."
"Sacral neuromodulation has shown long-term effectiveness in treating voiding dysfunction," Zaslau said. "This device should be considered by those who have failed other therapies but are motivated to achieve a cure in their disease."