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Preop information for Interstim testing
Post op information for Intersting testing
Preop information for Implantation
Postop information for Implantation
Indications for therapy:
- Overactive Bladder (OAB)
- Urgency/frequency
- Getting up at night too often to urinate
- Incomplete bladder emptying
- fecal incontinence (poor bowel control with seepage or leakage)
- may help chronic constipation
- may help IBS like symptoms
- will help improve pelvic floor muscle tone
Office testing - at Total Care for Women:
- Office medical evaluation including history and physical exam and labs with urine culture
- Scheduling for complete Urodynamic testing at Rush Hospital exam area with a Bladder Health Network technician and report generation by Urogynecology - report sent to Dr. Purdy.
- Trial use of anticholingeric medication - required by insurance providers including government programs such as Medicare and Medicaide programs
- Re-evaluation of clinical condition condition on medication
- Scheduling for Interstim testing if medication therapy fails to improve the patient.
- History and Physical exam at Total Care for Women
- Labs at Rush Hospital outpatient surgery department
- Arrive at scheduled date and time with a person or relative to drive you home after the procedure due to sedation with the procedure; the procedure date will always occur on a Monday!
- NPO - nothing to drink or eat from the previous midnight before the planned procedure date
Postop from Interstim testing:
- Depart from ambulatory care center at Rush Hospital after the temporary peripheral generator is programmed by the Medtronic technician
- No driving a car during the testing period (3 days)
- Sponge bathing only for the next three days in order to keep the sacral skin dry and prevent loosening of the dressing over the test electrode exit site on left and right side of the sacral region of the back
- Limited body activity in order to prevent the taped electrode wires from migrating and inadvertently changing the precise electrode wire placement with the procedure and interferring with the testing period of 3 days
- The Medtronic technician will contact the patient daily for a review of the voiding diary
- Return on the next Thursday for removal of the temporary Interstim test electrodes in the office at Total Care for Women.
- Reassessment of the Interstim testing on left and right sides of the sacrum. If the patient has greater than 50 percent improvement over the preoperative condition, then the patient will be scheduled for a single implant on the best side.
- No new labs unless time time interval between testing date and the implantation date is greater than a month
- Short History and Physical exam will be performed on the day of the removal of the test electrodes at Total Care for Women
- Arrive at scheduled date and time with a person or relative to drive you home after the procedure due to sedation with the procedure; the procedure date will always occur on a Monday!
- NPO - nothing to drink or eat from the previous midnight
Postop from Interstim Implantation:
- Depart from ambulatory care center at Rush Hospital after thei mplanted Medtronic generator is programmed by the Medtronic technician
- No driving a car for 48 hours due to sedation during the implantation procedure
- Shower for one week and avoid getting the skin incisions wet. The two small incisions are sealed by tissue glue with deeper self dissolving sutures.
- Resume normal activities as toleratered as soon as the patient is alert and awake.
- Follow up appointment in 2 -3 weeks. at Total Care for Women
- Discontinue any anticholinergic medication unless advised to use the medication as perscribed by Dr. Purdy; usually no antibiotic will be dispensed and narcotic medication is not usually needed or required postoperatively
- Resume upon discharge normal home medications