Coin-sized device helps Scots spend penny in comfort; MARIA CROCE talks to two patients whose lives have been transformed thanks to bladder aid.
SCOTS docs have been treating patients with embarrassing bladder problems by implanting a groundbreaking battery device in their backs.
The device - like a pacemaker - is the size of a pounds 2 coin and sends electrical pulses to the sacral nerves at the base of the spine.
The treatment has been hailed a success for dramatically improving the lives of patients who suffer problems like urinary incontinence or have to use catheters.
NHS Greater Glasgow and Clyde brought treatment to Scots for the first time.
The device is expected to last five years before it needs replacing and cured bladder problems in many patients.
Permanent sacral nerve stimulation (SNS) can eliminate the often embarrassing and inconvenient symptoms of urinary incontinence. Patients treated so far have ranged in age from 19 to 80.
Consultant urologist Graeme Conn, who delivers the service with a team of urologists, a specialist nurse and physicist, said: "This is proving to be very successful treatment and our patients of all ages are responding well."
SNS works by electrically stimulating sacral nerves. The patient is fitted with battery device - like a little pacemaker - under the skin in the lower part of the back.
An electrode sits against the sacral nerves and delivers mild electrical pulses to retrain the bladder control nerves. The battery is in a titanium cover and can be fitted in day surgery under a general anaesthetic.
Patients then need a yearly check-up.
Before the permanent device is fitted, patients undergo a trial test to see if SNS will help.
A thin wire is inserted in the lower back under local or gen minutes.
Checks are then done by sending electrical pulses to the nerves.
Mr.Conn explained: "Clinical staff a wireless device allowing programming of the stimulation and simpler controller for the patients allows them to adjust the level of the stimulation, or turn it off.
Patients feel a tingling or pulsing sensation, which is not unpleasant."
The sensation has been compared TENS machine used by some pregnant women during labour.
First reports show it has been a success, not only with incontinence but treating a rare condition that affects young to middle-aged women who stop passing urine and find it hard to use a catheter.
It is proving successful in treating people with an overactive bladder and those whose bladders don't empty.
It is not suitable for stress incontinence but can work with certain bowel problems.
CASE STUDY DAVID
JOINER David Archibald feared he'd have to give up his career after his bladder stopped working.
Now David, 27, from Falkirk, is looking forward to marrying fiance Susan Conlin, 26, who is a nurse, successful SNS changed his life.
David's problems after he was diagnosed with glandular December 2007, caused liver damage.
Then a year-later his bladder working. lems began iagnosed r fever in 7, which amage. and-a-half er stopped
David said: "fitted at my age difficult and it confidence. I spells off work whole period, very difficult, struggled with socially. "Moving from bag to catheterisation gave me a bit more freedom but was hard to get used to.
"I thought I was going to have to find a clean environment to use t catheter, which was difficult while working as a joiner.
"It was also a very embarrassing condition.
"I didn't want to go o with my friends and hav take a rucksack along w catheter."
After the implant in Ja was able to pass urine wi catheter for the first tim months.
He feels bac normal and is lo forward to wedding the str deali blad pro January he without a time in 18 back to looking his without stress of dealing with a bladder problem.
CASE STUDY BRENDA
PHYSIOTHERAPY lecturer Brenda Bain would often have to rush to the toilet every few minutes - and faced the fear of not getting there in time.
Brenda, 49, who lives near Glasgow, would regularly need the toilet without warning and had to suffer the embarrassment of incontinence accidents.
But now she's had the SNS implant, she no longer has problems and can take her dog Harry for walks without worrying she's too far from a toilet.
Brenda explained: "I've always had a weak bladder, but in my 40s this gradually got worse and I found I was going to the loo a lot more than usual and also with increasing urgency.
"It was very difficult going out anywhere as I could be absolutely bursting, even within five minutes of leaving the house. I could go to the loo several times within half an hour. Plus I could be up to the loo several times at night.
"I tried not to let it interfere with my life, but I was once in a shop and I couldn't get to a toilet in time, which was really embarrassing. I'd have to take a change of clothes with me in case of accidents."
Brenda was diagnosed with an overactive bladder that wasn't emptying properly and she was eventually fitted with the implant.
"The procedure itself was done under general anaesthetic and I was surprised how I felt absolutely no pain or discomfort afterwards.
"It's so unobtrusive - you hardly know you've got it. The medical physicist tweaks the programs to try to get the best stimulation and my symptoms have continued to improve ever since I had the SNS implant over a year ago.
"Now my bladder is much calmer and almost completely back to normal. I can go several hours without having to go to the loo, instead of every five minutes, and I can walk my dog without bursting for the loo several times within half an hour.
"I'm more confident going out places without needing to know where the nearest loo is.
"I am so grateful for being given the opportunity to have the implant.
The team are so expert in their care and are extremely dedicated to developing the service, so they can help improve the lives of more people with such a distressing condition."
EXPERTS Urologist Graeme Conn and Doug Small IMPLANT Tiny device is placed in the small of the back