by Kylie Blanchard

Incontinence impacts people of all ages and many suffer in silence, believing the symptoms are a permanent part of their lives. “Incontinence affects women and men, as well as children,” says Melanie Schlittenhardt, nurse practitioner at the Mid Dakota Clinic Center for Women. “Incontinence is the inability to control bladder or bowel contents. Bladder loss, also referred to as urinary incontinence, is very common. Most studies report that 25 to 45 percent of women experience urine loss. In addition, some sources report that 15 percent of women leak stool.” 



“Some people think urine or fecal loss is a normal part of aging and there is little to offer for treatment, but there have been a lot of advancements,” she adds.



There are many causes of bladder and bowel incontinence including neurological conditions, injuries, genetics, pregnancy and childbirth. A majority of the time, however, incontinence is idiopathic or without an identifiable cause. “Traditionally we start with Kegel exercises and bio-feedback treatments and, dependent on the type of incontinence, we may also use medication or surgical repair,” Schlittenhardt notes. 



There are different experiences and types of urinary incontinence, including stress incontinence, marked by the loss of urine with exertion, and urge incontinence, which is urine loss secondary to an urge. “If other treatments have failed or if the patient is intolerant of the treatments, we can now use an implantable device called InterStim®, which is often called a pacemaker for the bladder,” she says.



InterStim® targets the communication between the brain and the nerves that control the bladder and helps patients regain control of their lives. “We have been offering the treatment for five years for urge incontinence, urinary frequency, fecal incontinence and incomplete bladder emptying. We have tested 100 women for the treatment and implanted 85 devices,” Schlittenhardt says.



She notes, although incontinence is not life threatening, it has significant impacts on a person’s quality of life. “Incontinence increases the rate of depression, it is a financial burden, often costing individuals up to $3,500 a year for protective undergarments, and it affects activities of daily living and intimate relationships. It often takes women seven years to ask for help from a provider,” says Schlittenhardt. “This deserves treatment and we can offer hope and improve the lives of many people.”

Darlene Danielson, 72, lived with the symptoms of incontinence for many years. “As I got older it got worse. I tried every medication that was available and did all the exercises and therapies,” she says. “I was just hoping it was working and I started to think, ‘this is as good as it is going to get.’ The longest I could hold my urge was 30 seconds, and that was never long enough to get to the bathroom. I had many embarrassing moments.”

Danielson was using the bathroom up to 15 times a day and getting up two to three times each night, as well as leaking frequently. “I tried changing what I was eating and drinking and I always had a change of clothes on hand.”

In the spring of 2007, she was told about the InterStim® device. “I said ‘tell me when and where.’ I just wanted help.”

Danielson had to travel out of the state to have the device implanted in April 2007. “It changed my life and I would do it again in a heartbeat,” she says. “I no longer have to look where the bathroom is when I go places. I was always living around my bladder and I no longer have those issues.”

Danielson is now a patient ambassador for Medtronic, the company that created the InterStim® device, and has talked to over 300 people about the device and its impact. “A lot more people have this problem than we realize,” she says. “I want them to know they don’t have to live like that.”

Roberta Brown, 52, says her earliest memory of experiencing incontinence symptoms was when she was nine-years-old. The symptoms led to feelings of depression and hopelessness. “I felt like there wasn’t really anything I could do about it,” she says.

In 1997, she began a series of medications, therapies and Kegel exercises, and, in 2009, after moving to Bismarck, she was referred to the Center for Women. “The staff was so understanding and approachable, which made a big difference dealing with something I didn’t want to talk about. They gave me some options to try and I said I would go with any treatment they suggested.”

Brown was told she was a candidate for the InterStim® implant and she opted for the device. “It changed every aspect of my life – my personal life, my work, everything,” she says. “I don’t have the depression or the embarrassment, and I am able to do a lot of things I couldn’t before.”

Brown says she would recommend the InterStim® treatment to anyone who is experiencing the symptoms of incontinence. “It is something they definitely need to consider. I would tell them it will just make a world of difference,” she notes. “It’s like you are able to start living again. It’s a wonderful feeling to have control again over an area of your life that you haven’t had control of for so long.”

Marcy Alyea, 36, gave birth to her second daughter in the spring of 2004 and began experience symptoms of incontinence in the following months. “At first, I thought I just had to pee all the time, but it got to the point where there was constant leaking and irritation,” she says. “That’s when I thought, ‘I need to get this checked out.’”

Alyea’s first course of treatment was a bladder sling, done through a surgical procedure, followed by incontinence medications, but she was met with minimal results.

She says she got to the point where she was constantly looking for a bathroom. “We had tickets to go to a concert and I didn’t even want to go. I avoided everything because I always had to go to the bathroom.”

“I was so young and thought, ‘this can’t be incontinence. It will get better.’ But it doesn’t get better,” she adds.

In December 2010, Alyea received the InterStim® implant. “Incontinence literally affected my life so much and I didn’t even realize it until I got the InterStim® device. It was a life saver,” she says.

She says it is important individuals experiencing the symptoms of incontinence contact their doctor. “If you are experiencing any of the symptoms you know it’s irritating, it makes your life uncomfortable,” says Alyea. “It’s frustrating and depressing, and it’s not a way to live.”

For additional information on the InterStim® device and the treatment of incontinence contact Continence Management at Mid Dakota Clinic Center for Women at 1-800-472-2113 or 530-6186.