Getting an Evaluation
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About the evaluation
If you have not had success with other conservative treatments or could not tolerate them, talk to your doctor about the evaluation for Medtronic Bladder Control Therapy (Sacral Neuromodulation). During the evaluation, you'll have the opportunity to test Medtronic Bladder Control Therapy before making a long-term commitment. The evaluation generally lasts several days. Before and during the evaluation, you'll be asked to track your symptoms to help determine how well Medtronic Bladder Control Therapy works for you.
If you've tried several treatments for overactive bladder without success, don't lose hope. There may be another option: Medtronic Bladder Control Therapy (Sacral Neuromodulation).
With Medtronic Bladder Control Therapy's two-step process, you can test it out to see if it will work for you before making a long-term commitment. The testing period is called an "evaluation"or a "trial assessment."
Your doctor will tell you about the evaluation procedure and discuss the options for using either a temporary lead (a thin wire) or a long-term lead for the evaluation.
Determining success
You and your doctor will decide together whether your evaluation was successful. The evaluation is considered a success if you experience a significant reduction in your symptoms.
For example, your evaluation may be considered a success if you went to the bathroom 20 times per day before the evaluation and went 10 or fewer times during the evaluation.
The evaluation process
The evaluation starts with a minimally invasive outpatient procedure usually done in your doctor's office or in an ambulatory surgery center.
For the basic evaluation, which uses a temporary lead, your doctor will numb a small area of your upper buttock and insert a thin wire near your sacral nerves, located near the tailbone. The advanced evaluation uses a long-term lead that is fully implanted; one end of the lead is inserted near your sacral nerves. With both types of evaluations, the lead is connected to a small, external neurostimulator that you'll wear on your waistband like a pager. The neurostimulator generates mild electrical pulses that are carried to the sacral nerve by the lead.
The length of the evaluation may vary among doctors and depends on the type of evaluation you undergo. Generally, if the temporary lead is used, the evaluation period lasts from 3 to 7 days; if the long-term lead is used, the evaluation period may last up to 28 days.
Complications can occur during the evaluation, including movement of the wire, technical problems with the device, and some temporary pain. In most cases, these issues can be resolved, so talk to your doctor about your experience.
During the evaluation, you will need to use a symptom tracker to write down your urinary symptoms, such as how many times you go to the bathroom and whether you have leaks. You should be able to work and continue your normal activities, as long as you avoid lifting, bending or twisting movements. If you experience a significant reduction in your symptoms, you and your doctor can discuss long-term Medtronic Bladder Control Therapy.
Support during the evaluation
Your doctor will be your primary source for support and information during the Medtronic Bladder Control Therapy evaluation.
As you begin the diagnosis and treatment of overactive bladder, you may meet a variety of medical professionals dedicated to giving you their best possible care. It’s important to be honest and straightforward with your health care providers about your symptoms, lifestyle, and treatment concerns.
Urologist
Urologists are surgeons who specialize in diseases of the male and female urinary tract and the male reproductive organs. Some urologists have specific experience in female urology and the treatment of incontinence.
Gynecologist
Gynecologists specialize in women's general health, including care of reproductive organs, breasts, sexual function, and hormonal disorders. Gynecologists also treat pelvic organ and urinary tract problems.
Urogynecologist
Urogynecologists specialize in diseases of the female urinary tract and pelvic reconstructive surgery. They also treat prolapse and bladder control problems, including incontinence.
Urodynamics Nurse
Urodynamic tests are usually conducted by nurses specializing in urodynamics. The test is a diagnostic procedure used to evaluate your bladder function. The results of these tests help your doctor decide which treatment is right for you.
Nurse, Nurse Practitioner or Physician Assistant
A nurse, nurse practitioner or physician assistant typically works closely with your doctor. He or she may answer questions, and advise you on treatments such as Kegel exercises, fluid and diet modification, or physical therapy.
Physical Therapist
Your doctor may prescribe physical therapy to strengthen the muscles in your pelvic floor. Pelvic floor rehabilitation may include pelvic floor stimulation and biofeedback-guided pelvic floor exercises, used alone or in combination.
Will my everyday activities be affected during the evaluation?
You should take it easy during the evaluation. Avoid bending, stretching, or lifting heavy objects. You can usually continue to work throughout your evaluation if your job doesn’t require strenuous movement. Be aware that the evaluation wire can move. Keep your activity level low to moderate.
1
Elterman, D, Ehlert, M, De Ridder, D, et al. A prospective, multicenter, international study to explore the effect of three different amplitude settings in female subjects with urinary urge incontinence receiving interstim therapy. Neurourol Urodyn. 2021; 40: 920– 928. https://doi.org/10.1002/nau.24648
Medical disclaimer
Information contained herein is not medical advice and should not be used as an alternative to speaking with your doctor. Discuss indications, contraindications, warnings, precautions, adverse events and any further information with your health care professional.