Bladder Incontinence and the Percutaneous Nerve Evaluation
There are many important things that you should consider prior to having a permanent bowel implant operation. Metropolitan Urological Specialists in St. Louis, Missouri wants to give you an overview of some of the symptoms that could lead to this type of procedure and then let you know about an important test that your physician may recommend that you take prior to the procedure.
What are “bothersome” bladder symptoms?
• Leakage of large or small amount of urine
• Urinating often
• Urinating urgently
• Getting up at night to urinate
• Inability to completely empty the bladder, or may be not able to urinate at all
What are “bothersome” bowel symptoms?
• Fecal leakage
• Fecal smearing
How common are bladder control problems?
• Over thirty-three million people (1 in 6 adults) suffer from urinary control problems in the United States alone.
• These problems may impact men and women.
• It might affect individuals of all ages; it is not just a normal part of aging.
How common are bowel control problems?
• Over 18 million men and women or 8.3% of adults suffer from symptoms of bowel control.
• Probably more prevalent than reported because of the embarrassing nature of condition.
What are the causes of “bothersome” bladder and bowel symptoms?
• There might be multiple causes; including, injury, side effects from particular medications, neurologic diseases, infection, bearing children, pelvic pain, and others.
• Dr. Naughton, one of Metropolitan Urological Specialists’ top physicians makes it a high priority to rule out medical causes of “bothersome” bladder and bowel symptoms. Then, based on how these symptoms affect quality-of-life of the individual, she will make suggestions on treatment plans.
Prior to placement of the permanent implant, your doctor may recommend a Percutaneous Nerve Evaluation. A Percutaneous Nerve Evaluation (PNE) is an easy office test which gives you an opportunity to test two temporary leads (or wires) into the pelvic nerves. Under local anesthesia in an office setting, 2 temporary leads are put on each side of the pelvic nerves. The leads are fixed to the back and attached to an external battery the size of a beeper. The patient will get the chance to test both leads over the next three to five days to find out if there are any changes to the bladder or bowel symptoms. We consider a fifty percent improvement in symptoms a positive test, which makes the individual a candidate for implantation of the permanent device.
What to know about the Percutaneous Nerve Evaluation (PNE) Procedure
1. Please get there 30 minutes prior to your scheduled appointment time.
2. You may drive yourself to the procedure; however, it is preferable to have someone drive you to and from the procedure.
3. This procedure is carried out in the office under local anesthesia.
4. Do not eat 2 hours prior to your procedure. A light snack or meal is acceptable 2 hours before your procedure.
5. Quit aspirin and ibupfren products (Motrin, Alleve, etc.) at least five days prior to your procedure.
6. Let our scheduler know if you're taking blood thinners, like Coumadin (warfarin), Xaralto, etc.
7. No baths or showers while in the test period.
8. Abstain from heavy lifting or excessive bending during the trial.
What to expect on the day of the PNE procedure:
1. You will meet a medical assistant and agent(s) from Medtronic; the product company.
2. You will be told to lie on your stomach. The medical assistant will clean off your back and buttocks.
3. Dr. Naughton will do the procedure with the help of the Medtronic agent.
4. The Medtronic agent and the medical assistant will secure the leads to your back, wipe off the cleaning solution on your back and buttocks before you get dressed.
5. Following the procedure, you'll talk with the Medtronic representative to review voiding and bowel diary instructions and arrange contact plans with the representative to talk about changes in your urinary and bowel function throughout the trial period.
6. You will make an appointment to see Dr. Naughton in 3-5 days in the office before you leave to remove the leads and discuss the results of your trial.
If you've got any questions before the procedure, contact the procedure scheduler at the offices of Metropolitan Urological Specialists at 314-315-9933 during regular business hours. If you have questions about this procedure or anything else associated with bladder problems, schedule an appointment with one of our offices in the St. Louis area, including Washington, Florissant, and Creve Couer, Missouri.
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