Urinary incontinence affects between 15% and 30% of American adults living in the community, and as many as 50% of people confined to nursing homes. It is a disorder that affects women far more frequently than men; 85% of people suffering from urinary incontinence are women. According to the chief of geriatrics at a Boston hospital, 25 million Americans suffer each year from occasional episodes of urinary or fecal incontinence.
Interstitial cystitis is less common than urinary or fecal incontinence but still affects 700,000 Americans each year. The average age of IC patients is 40; 25% of patients are younger than 30. Although 90% of patients diagnosed with IC are women, it is thought that the disorder may be underdiagnosed in men.
Sacral nerve stimulation (SNS) is conducted through an implanted device that includes a thin insulated wire called a lead and a neurostimulator much like a cardiac pacemaker. The device is inserted in a pocket in the patient's lower abdomen. SNS is first tried on an outpatient basis in the doctor's office with the implantation of a test lead. If the trial treatment is successful, the patient is scheduled for inpatient surgery.
Permanent surgical implantation is done under general anesthesia and requires a one-night stay in the hospital. After the patient has been anesthetized, the surgeon implants the neurostimulator, which is about the size of a pocket stopwatch, under the skin of the patient's abdomen. Thin wires, or leads, running from the stimulator carry electrical pulses from the stimulator to the sacral nerves located in the lower back. After the stimulator and leads have been implanted, the surgeon closes the incision in the abdomen.
Nancy McKenzie PhD, The Gale Group Inc., Gale, Detroit,