Decision Time: Broken Interstim vs. Botox

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In 2017 I had an Interstim device implanted to reduce urinary urgency and frequency. It worked for a while and then stopped working. I gave up on the device after trying to adjust it a few times. I recently had the Medtronic rep. analyze it. She learned that the wire is not working properly and the battery is down to 40%. She suggested I have it replaced with a new device that also allows me to have an MRI, which is not allowed with the current older version. I'll eventually need an MRI for a lower back condition. I also fell backwards this morning and now I think the battery in my right butt cheek is broken in two pieces.

Here's my dilemma: I'm 71 years old and trying to decide if I should have the newer model Interstim device implanted or if I should go with Botox injections in the future. After having 65% of my prostate removed on March 4 of this year for BPH, urgency and frequency are still a concern. My doctor thinks I may have OAB which still needs to be determined.

Does anyone have a situation similar to mine? Would anyone care to offer me advice?

Thank you.

 

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I have had two Interstim implanted. Neither worked for me. Botox works sometimes and other times it doesn’t. The Botox injections are more for my excruciating bladder pain. Wish it would always work because I hate living with this constant Interstitial Cystitis pain.

 

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Botox causes a paralysis of the bladder muscle - depending on how strong it is, it helps with OAB because it prevents the bladder from spasming. If the dose is too strong, it can cause urinary retention and you have to do ISC until the effect wears off.

Unfortunately, Botox does not work on the actual problem of IC. This is usually due to a problem with the GAG layer of the bladder wall or the bladder wall itself. In IC, instillations with chondroitin sulfate may be the better choice, especially since they do not carry the risk of urinary retention.

Regarding the problem of prostate removal, there may be mixed incontinence. If this is the case, Botox and interstim will only help to a limited extent, because they can only treat the OAB but not the stress incontinence. Furthermore, it should be considered that the Botox treatment must be repeated at regular intervals (lasts about 6 - 9 months). If the Interstim worked well, I would think about a replacement.

However, if there is stress incontinence anyway, the options should be discussed again with the urologist. Possibly ligaments can be used (yes - this is also possible for men) to support the sphincter muscle. However, this presupposes that it is still in good condition. If this is not the case, the question arises whether Botox and Interstim still make sense or whether an alternative treatment must be considered.

 

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If your Interstim isn't working, and especially if the unit itself is broken in pieces, I'd think at a minimum it would need to come out. If it worked at first, it seems that you're a good candidate for it. Given that you need surgery either way, and Interstim works for you, I'd go ahead and get it replaced it it were me.

If the Interstim isn't getting you to where you want to be, you always have the option of getting Botox as well.

 

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Since I have an InterStim device myself, I would be very concerned about a broken device.

The devices are made of a very strong metal (titanium) shell that contains a lithium battery and computer circuit board. If it were broken I would be concerned about lithium being exposed! I would expect there to be damage to internal tissue such as burns and bleeding.

NOTE: Hematomas are very painful and can require hospitalization and blood transfusions. Unrelated to the InterStim, I once spent 10 days in the hospital recovering from a hematoma down my left leg. Very painful!

Before my first implant I thought about where I wanted my device to be placed. I have no fat for padding on my butt, so putting it there would be very uncomfortable. (Sitting is already a pain in the butt for me.) I also wear a wide belt that carries personal, defense equipment, which is quite heavy. I also considered that I sleep on my left side. So, I told the surgeon to place the InterStim device above my belt line, over my right kidney. This has worked well for me.

May God bless you!

 

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@Fleemore,

My first question would be, did you have excellent trouble free relief of your symptoms when the existing one worked? If so then the new one could possibly provide an effective solution as well.
It sounds like you’ve been walking around with the equivalent of a potentially dangerous Hockey Puck in your body, and who knows where the wires have possibly migrated to?
This is an invasive surgery no matter what they tell you. I was so desperate for pain relief I let them go in and out of my back 5 times in order to relocate the stimulator itself, it kept moving around (Which of course they said would NEVER happen”). I developed a massive infection on my left side and was misdiagnosed with MERSA. The treatments for the MERSA which I never had, then killed all of my teeth! $104,000.00 later I have my jaw repaired and a full set of teeth again.
The stimulator them moved again, now shocking my heart into arrhythmia and almost killing me. I have had to be shocked back into rhythm about 2x per year for the last 6 years because of that thing, and I guarantee you it is NO FUN! The stimulator was finally removed via emergency surgery as I was having a massive heart attack at 43 years old, caused by the stimulator which they couldn’t stop until they cut the leads. See heart attacks hurt, a lot! The more pain I was in the more it shocked my heart because the leads had migrated to my pericardial sac, which of course I was assured could never happen.
With surgery, anything can happen; I’d weigh my options very carefully….

 

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I love love love Botox. I’d get that failed/broken interstim removed ASAP.

 

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@MezaJarJarBinks

Thank you for this Interstim info. It is very valuable.

Best,

fleemoore