Private InterStim therapy for faecal incontinence

Faecal incontinence, (also known as bowel incontinence), can affect both men and women in various ways. Faecal incontinence refers to the inability to control bowel movements, which can result in soiling oneself without feeling the need to use the toilet, experiencing sudden and uncontrollable urges to pass stools, or leaking stool when passing gas. This condition can occur occasionally, or on a daily basis. 

Bladder Health UK suggests that faecal incontinence could affect between one in ten people in the UK. Many people dealing with faecal incontinence finds it difficult to leave the house with confidence and can experience social embarrassment and emotional distress.

Faecal incontinence can be caused by various factors. The most common cause of faecal incontinence is damage to the nerves and muscles of the back passage (anal sphincter) that control the bowel movements.

Damage to the nerves and muscles can be caused due to injury, surgical complications, or childbirth.

Long term medical conditions such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), severe constipation and diarrhoea can contribute to faecal incontinence.

Other conditions affecting your ability to control bowel movements may include rectal prolapse, rectocele and advancing age. 

Faecal incontinence can significantly impact a person's emotional and psychological wellbeing, regardless of their age and ability.  This condition can be highly distressing, and people often feel embarrassed or find it difficult to discuss or accept support from loved ones. This, in turn, can affect their ability to work, enjoy leisure and maintain social activities and friendships. 

There are lots of treatments for faecal incontinence that can help reduce the impact that it has on your life.

Treatments for faecal incontinence vary, depending on the underlying cause and the severity of the condition. A combination of treatments may be used to manage faecal incontinence effectively.

Do not try to deal with faecal incontinence by yourself, the specialist team can help you manage or treat your condition to improve your quality of life.

The best treatments depend on what the underlying problem is. Our Consultant General and Colorectal Surgeons in the colorectal surgical team would be glad to review your case, to help find out the cause of your issues, and ultimately improve your symptoms and quality of life. Possible treatment options include:

• lifestyle and dietary changes              
• medications
• bowel retraining with specialist physiotherapy input
• incontinence products such pads or pull up pants
• surgical treatments, including medical devices such as sacral neuromodulation therapy with the InterStim™ System

Sacral neuromodulation therapy with the InterStim™ System is a medical treatment used to manage chronic faecal incontinence by stimulating the sacral nerves (a part of the human peripheral nervous system) located near the tailbone, which controls the bowel, bladder, and pelvic floor muscles.

This therapy involves the implantation of a small device, known as a neurostimulator, under the skin of the lower back or buttocks. This device (which works like a pacemaker) sends mild electrical pulses to the sacral nerves through a thin wire (lead) placed in your spine near these nerves.

The procedure is usually performed in two stages:

1. Test phase (evaluation): a temporary lead is placed in your lower spine near the sacral nerves, and an external stimulator is used to test the patient's response to the therapy.  The patient would have this on for 2 weeks. The patient lives their life normally while maintaining a bowel diary to see if they are experiencing an improvement in their symptoms of faecal incontinence. If significant improvement is observed during this trial period, the patient may proceed to the next stage. For this initial evaluation phase, the patient attends the hospital as a day case. This part of the procedure is performed under local anaesthetic and takes around 30 minutes. It is estimated that 75% patients will have a successful trial (a successful trial means that they received a greater than 50% improvement in bowel symptoms).

    

2. Implantation phase: a permanent neurostimulator is implanted under the skin over the right or left buttock area, and the temporary lead is replaced with a permanent one. The device is then programmed to deliver the appropriate level of stimulation. The patient attends the hospital as a day case. This part of the procedure is performed under local anaesthetic and takes around 60 minutes. The patient would then have their permanent device activated either on the same day or one week after the operation. The implantation will be followed up in the longer term via outpatients clinic appointments.

The InterStim™ System is around the size of a two-pound coin and is controlled by a programme which is uploaded to your mobile phone. Patients can still undergo a full-body MRI if needed if they have the neurostimulator implanted.

The battery life for the neurostimulator varies depending on the model used:

• The InterStim™ X System is a re-charge free. Powered by an innovative battery, it delivers more than 10 years of results, with battery life expected to reach 15 years in patients with low levels of stimulation.

   

• The InterStim™ Micro System is powered by a battery that delivers 15 years of results with a weekly recharge that takes 20 minutes if the device has low stimulation parameters.

Sacral neuromodulation therapy can help restore normal communication between the brain and the bowel, improving their function and control. This may help you resume normal activities and avoid frustrating and embarrassing experiences with faecal incontinence.

The treatment can be reversed at any time by turning off or removing the neurotransmitter device. 

The selected Consultant General and Colorectal Surgeons who offer this procedure are happy to see anyone with issues or concerns with their bowel control and function.

The patient’s case will be reviewed at a specialist clinic by a Consultant Colorectal Surgeon who has expertise in this condition.

Most patients being considered for this implant will require a colonoscopy (endoscopic examination of the large bowel and the distal portion of the small bowel) or flexible sigmoidoscopy (using a narrow, flexible tube with a camera to look inside your rectum) to assess their bowel. This is to ensure that there is no other cause for their symptoms.

Further investigations, such as colonic transit studies (to look at how quickly faeces passes through your bowel) and an MRI defecating proctogram (to look at what happens to the inside of the rectum when you open your bowels) may also be required.

A review by our specialist physiotherapy team will normally be carried out as part of our patient pathway.

Patients can self-refer or a referral from their GP to Albyn Hospital are both accepted.

The following consultants at Albyn Hospital who is offering this procedure are:

• Lynn Stevenson, Consultant General and Colorectal Surgeon
• Shafaque Shaikh, Consultant General and Colorectal Surgeon

You can contact Albyn Hospital on 01224 595993 to book an appointment. 

Alternatively, you can book an appointment online with either consultant by visiting their profiles

• Expert assessment from an experienced consultant: You be seen by the same consultant throughout your entire treatment journey.
• A multidisciplinary clinic: Your consultant is supported by several other healthcare professionals, such as nurses and radiographers. This multidisciplinary team approach ensures that you receive support and treatment from the most appropriate specialists.
• State-of-the-art imaging facilities: including X-ray, CT, MRI, and ultrasound. These diagnostic imaging procedures can be easily arranged, if required. Our radiologists work closely with our consultants to provide an accurate diagnosis as soon as possible.
• Treatment plans: tailored to meet your individual health needs.
• Fixed-price surgery packages.

A guide price for sacral neuromodulation therapy with the InterStim™ System

Phase 1 - Test phase £4,849.00

Phase 2 - Implantation stage: £18,894.00

_{Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.Prices do not include diagnostic tests or the initial consultation and follow-up appointments.} 

If you are paying for your own treatment, we offer flexible payment options that can help you spread the cost of private healthcare.You can choose a repayment time period to suit you, from one to five years. If approved, you can take advantage of interest-free credit when you choose a 10-month plan, or 9.9% APR if you pay over a longer period. Click here for further information