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PTNS vs. Interstim

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  • PTNS vs. Interstim


    I have recently been diagnosed with overactive bladder (potentially IC?) from a urodynamics test. I have been dealing with issues of frequency for about 17 years now - I am 43.

    The test showed detrusor overactivity (without leakage) at 60cc - roughly 60 ml. An 8-day voiding diary I kept corroborated the urodynamics results. I void between 7 and 10 times over 24 hours (2x per night), but usually only about 4-6 oz. at a time. No accidents ever. So I'm voiding more often but not very much. And my bladder is alerting me much sooner than it should.

    My doctor suggested 3 options: 1) anticholinergics, 2) botox, and 3) Interstim. I have taken ditropan and detrol in the past, and I don't remember how much relief or not I got. Recently, I was on 50mg Myrbetriq for about 6 months, and that did nothing. My doctor and I are both wary of Botox because of the high potential for it to cause urinary retention.

    I've read quite a bit about Interstim online and on this site as well. I understand the potential benefits, risks, and cost. However, somehow it feels like a giant leap given that my symptoms are relatively "mild" compared to others. In desperation, and to buy some decision-making time, I have decided to give the Oxytrol patch a go for a few weeks, and the doctor has also left me samples of Vesicare to try if the Oxytrol is not effective.

    However, if these do not work, I might be facing the Interstim decision.

    In my research on Interstim, I also discovered the post about PTNS as well as further literature online to its effectiveness. It's appealing because it's non-invasive. My Uro DOES offer PTNS, but my insurance does not cover it as it's "experimental" for them (thanks Cigna!). It would cost me $2400 for the 12 sessions.

    Does anyone have experience with PTNS and how effective it was? Is it worth the $2400 to "try"? The doctor said that if it were her, it wouldn't be worth it - that she would put the $2400 toward Interstim because it's more effective. She said they had a dozen patients who did PTNS and saw no improvement among any of them.