Type of Surgery
Last updated: 11/24/2009
There are three types of nonsurgical treatments that benefit some patients with IC:
- Behavioral approaches. These include biofeedback, diet modifications, bladder retraining, and pelvic muscle exercises.
- Medications. These include...
antispasmodic drugs, tricyclic antidepressants, and pentosan polysulfate sodium, which is sold under the trade name Elmiron. Elmiron appears to work by protecting the lining of the bladder from bacteria and other irritating substances in urine.
- Intravesical medications. These are medications that affect the muscular tissues of the bladder. Oxybutynin is a drug that is prescribed for patients who are incontinent because their bladders fail to store urine properly. Capsaicin and resiniferatoxin are used to treat hyperreflexia of the detrusor muscle.
Surgical alternatives to SNS are considered treatments of last resort for IC because they are invasive, irreversible, and benefit only 30â€“40% of patients. In addition, some studies indicate that these surgeries can lead to long-term kidney damage. They include the following procedures:
- Augmentation cystoplasty. In this procedure, the surgeon removes the patient's bladder and replaces it with a section of the bowelâ€”in effect creating a new bladder. The patient passes urine through the urethra in the normal fashion.
- Urinary diversion. The surgeon creates a tube from a section of the patient's bowel and places the ureters (tubes that carry urine from the kidneys to the bladder) in this tube. The tube is then attached to a stoma, or opening in the abdomen. Urine is carried into an external collection bag that the patient must empty several times daily.
- Internal pouch. The surgeon creates a new bladder from a section of the bowel and attaches it inside the abdomen. The patient empties the pouch by self-catheterization four to six times daily.
Much of the difficulty in brain surgery recovery comes with healing of the skull and covering of the brain. This video shows that a tumor in a particular location can be removed by entering through the nose, rather than the skull. The endoscopic endonasal approach or EEA is associated with rapid recovery times compared to most other types of brain surgery.
Sacral nerve stimulation, also termed sacral neuromodulation, involves the implantation of a programmable stimulator under the dura matar which delivers low amplitude electrical stimulation to the S3 or S4 root. Currently, the FDA has approved InterStim Therapy, by Medtronic, as a safe sacral nerve stimulator for treatment of Urinary Urge Incontinence, Urinary Frequency, and Urinary Retention. Sacral nerve stimulation is under investigation as treatment for a host of other conditions, though.
Neurosurgery is one of the longest training periods of all the medical specialties because of the extreme complexity of the nervous system and the advanced technique used in this specialty.
-Neuroscience & Spine Associates
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