If medications and dietary modifications aren't working for overactive bladder (OAB), your urologist may recommend neuromodulation. In the video above, Dr. Kathleen Kobashi, a urologist at Houston Methodist, explains how stimulating certain nerves can help make your leaky bladder behave.
(Related: What's the Best Treatment for Overactive Bladder?)
"Neuromodulation is the fancy word for a pacemaker," Dr. Kobashi explains. It's the same technology as a heart pacemaker, just used to instead help with bladder function instead. The nerves that control your bladder and bowel start in your lower back and travel down to your ankle. When these nerves are stimulated, it can help regulate the messages that control bladder (and even bowel) function.
Sacral nerve stimulation
- The technology: A small battery about the size of a silver dollar is implanted in your lower back. A thin wire, also called a lead, is then connected to the sacral nerve, near the vertebrae. This wire delivers pulses of electricity to modulate messages to the bladder.
- The test drive: In the office setting, the lead is implanted and you wear a temporary battery back around your waist for about 5-7 days to make sure the pacemaker helps the bladder behave better.
- The procedure: After this trial period, the urologist then implants the permanent battery under the skin in the operating room.
Percutaneous tibial nerve stimulation (PTNS)
"Up until just recently, we would need to trouble you to come in and see us in the office every week for 12 weeks to have this treatment, where we would use acupuncture to stimulate the nerve," says Dr. Kobashi. "Now, however, there are options for an implantable device, similar to the pacemaker we were talking about but we put it in the ankle."
An even smaller battery, about the size of a nickel, can be implanted in the ankle area, and the electrical lead stimulates the nerve similarly as above.
