Treatment pathway

For bladder and bowel symptoms


Take your first step toward freedom.

If you’re experiencing bladder or bowel symptoms,
there are steps you can take to find relief — and take back control.

Alert Important safety information

Steps to help bowel or bladder problems

Talking to your healthcare provider about your bothersome bladder or bowel symptoms can be uncomfortable, but you deserve long-lasting relief. Remember, if you have not experienced the symptom relief you want, more options are available.

Why am I having these symptoms?

Step 1:
Diagnosis

Reach out to a healthcare provider

Start by speaking with a healthcare provider. You may be asked to fill out a symptom tracker. This symptom tracker will help you and your healthcare provider have a meaningful conversation about your symptoms. 

What treatments are prescribed first?

Step 2:
Lifestyle changes

Could conservative treatments help?

Conservative treatments may help, and while they don’t work for everyone, they may be the solution you need.

Bladder control

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

Bowel control

  • Dietary modification: Changes may include adjusting fiber intake or eliminating troublesome foods.
  • Bowel retraining: This step aims to improve bowel sensation, coordination, and strength.

Could medications help?

Step 3: Medications

Trying medications

When lifestyle changes don’t deliver the results you want, oral medications may be the next step. These medications can help control symptoms but may have side effects. 

In one survey regarding bladder control, 72% of people said they stopped taking their medication after just six months.1 If medications don’t work, or if you experience intolerable side effects, don’t lose hope. There is more you can try.

Is there an option for long-lasting relief?

Step 4:
Advanced therapies

The InterStim™ system works differently

When exercises, lifestyle changes, and medications disappoint, you may be ready for a more advanced option. 

The InterStim™ system is a small, implantable device that targets the sacral nerves that control your bladder or bowel. It may help restore normal bladder or bowel function — giving you the long-lasting relief you deserve.

Targeting the sacral nerves that control bladder and bowel function,2-4 the InterStim™ system comes with a number of benefits:

  • A trial period with an external device, so you can try it before you commit
  • Greater effectiveness than medication alone5
  • An 82% success rate at five years6 for OAB patients and an 89% improvement for patients experiencing bowel control symptoms.7‡

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.

Patients have reported a 3 times greater improvement in quality of life with the InterStim™ system compared to using medications alone.5

Learn more

Additional advanced treatment options

For bladder control

Medtronic bladder control therapy delivered by the NURO™ system targets the tibial nerve to help you regain control of your bladder. By restoring§ bladder function, this therapy, sometimes called percutaneous tibial neurostimulation (PTNM), puts you on a path to fewer trips to the bathroom, fewer pads per day, and more of the activities you enjoy.8,9

With the NURO™ system, you get:

  • Restored bladder function8,9,§
  • Convenience of a non-surgical, in-office treatment
  • Resources and support

Most common side effects are temporary and include mild pain or skin inflammation at or near the stimulation site. The NURO™ system does not treat symptoms of urinary retention. 

Injected medications

Injected medications may temporarily treat symptoms but raise other concerns, including:

  • Repeated injections every three to six months
  • A potential need for  self-catheterization10
  • Increased risk of bladder infection due to self-catheterization10

For bowel control

A bulking agent

This gel is injected into the anal canal to thicken the tissues and improve symptoms of fecal incontinence (FI), but has some potential concerns:

  • Does not address bowel-brain communication
  • May cause unpleasant side effects

Other surgical options

Several other surgical options are available, all of which bring their own unique set of risks, including:

  • Anal sphincter repair
  • Artificial sphincter
  • Colostomy

 

Are you a candidate for InterStim™ therapy?

Answer a few short questions and find out if sacral neuromodulation may be a fit.

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*

Reflects overactive bladder patients.

Restored function defined as ≥50% reduction in dysfunctional bladder or bowel symptoms from baseline.

Success defined as ≥ 50% reduction of episodes per week. This patient group had data at both baseline and the five-year visit. Another analysis reported 69% of people achieved success with Medtronic bowel control therapy. For this patient group, missing data at five years because of a device-related reason was counted as failure or if it was missing for non-device related reasons, the most recent data was carried forward.

§

Restored bladder function is defined as a measurable reduction in urinary frequency and/or urinary incontinence episodes following treatment.

1

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.

2

Leng WW, Chancellor MB. How sacral nerve stimulation neuromodulation works. Urol Clin North Am. 2005;32(1):11–18.

3

Chancellor MB, Chartier-Kastler EJ. Principles of sacral nerve stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromod. 2000;3(1):15–26.

4

Patton V, Wiklendt L, Arkwright JW, et al. The effect of sacral nerve stimulation on distal colonic motility in patients with fecal incontinence. Br J Surg. 2013;100(7):959–968.

5

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 Mar;34(3):224–230.

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

Hull T, Giese C, Wexner SD, et al. Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum. 2013; 56(2):234–245.

8

Kobashi K, Nitti V, Margolis E, et al. A prospective study to evaluate efficacy using the NURO percutaneous tibial neuromodulation system in drug-naïve patients with overactive bladder syndrome. J Urol. 2019;131:77–82.

9

Kobashi K, Margolis E, Sand P, et al. Prospective study to evaluate quality of life with percutaneous tibial neuromodulation in drug-naïve patients with overactive bladder syndrome. Presented at the 2018 Annual Meeting of the International Continence Society.

10

Visco AG, Brubaker L, Richter HE, et al. Anticholinergic versus botulinum toxin, A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial. Contemp Clin Trials. 2012;33(1):184−96.

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.