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Newark, NJ -- A new procedure designed to help women manage urinary incontinence is being performed at Newark Beth Israel Medical Center, an affiliate of the Saint Barnabas Health Care System.
Emad Hashemi, MD, Chief of Urogynecology and Pelvic Reconstructive Surgery at Newark Beth Israel, was the first to perform this minimally invasive surgery at the hospital.
The FDA-approved procedure, called interstim sacral nerve stimulation, uses a pacemaker implanted into the bladder to control urinary frequency and flow. Over 40 percent of women in this country suffer some form of urinary dysfunction.
The procedure is designed to treat stress incontinence (urine leakage caused by coughing, sneezing or strenuous activity). This occurs mostly in younger women after childbirth. It also helps those with urge incontinence (the constant need to urinate), which can be caused by bladder infections or major conditions like stroke.
TWO-STAGE PROCEDURE
The pacemaker, or neurostimulator, used by Dr. Hashemi is similar to those used in heart patients. The device is two inches wide, weighs 22 grams and has a wire lead attached to a battery. The procedure is done in two stages.
During the first, the lead is surgically implanted close to the sacral nerve located near the tailbone. The sacral nerve influences the bladder and muscles that manage urinary function.
After the lead is inserted, the battery is worn outside the body for two weeks while the electrical pulses are adjusted to control the patient's bladder symptoms. This part of the procedure takes one hour and the patient goes home the same day.
The second stage is the permanent placement of the wire and neurostimulator. The stimulator is surgically implanted under the skin of the buttocks. The patient can control the level and frequency of pulses with a hand-held remote control. If the patient feels an urge to urinate, she can increase the electrical level on the pacemaker and the urge will subside. The stimulator battery lasts seven to ten years, and is checked routinely every four months.
NINETY PERCENT SUCCESS RATE
According the Dr. Hashemi, "Many women feel that incontinence is a normal part of aging. It is not, and if left untreated, it can interfere with daily activities and quality of life."
He adds that with the bladder pacemaker, "Our success rate for managing urinary incontinence is close to 90 percent."
Lisa McCain of Elizabeth is a 42-year-old mother of three who recently underwent the procedure. Mrs. McCain had chronic urinary tract infections for nearly a year. She would urinate every half-hour during the day and would wake up eight or nine times during the night. "I got little or no sleep for months. I couldn't function," Mrs. McCain said.
When a series of medications did not relieve her symptoms, Dr. Hashemi implanted the bladder pacemaker. "I had relief within three days," said Mrs. McCain. "I'm back to doing everything I used to do. It's amazing. I'm even able to sleep through most nights," she adds.
"In this patient's case," adds Dr. Hashemi, "we had a 100 percent change of symptoms. We achieved a great result with maximum benefit."
FOR MORE INFORMATION
For more information about this procedure, please contact the Department of Urogynecology at 973-926-7342. Dr. Hashemi is a board-certified OB/GYN who specializes in treating disorders of the lower urinary tract and pelvic floor. He sees patients at Newark Beth Israel Medical Center, Newark, and at Urogynecology and Advanced Gynecology Medical Group in South Orange, NJ.
The Division of Urogynecology is part of the Department of Obstetrics and Gynecology, which provides comprehensive care for women of all ages. In addition to urogynecology, the department has specialists in reproductive endocrinology, maternal-fetal medicine, and gynecologic oncology. State-of-the-art equipment includes 3-D and 4-D ultrasound technology and the daVinci Surgical System for robotic-assisted GYN procedures.
Date: January 3, 2008
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