My 82 year old wife has many problems, but I am now focusing on her overactive bladder. I have an appointment next week with a specialist when I am going to ask about Sacral Neuromodulation, which is the implanting of an electrical device that stimulates the nerve that controls the bladder. Has anyone tried this procedure? Has it been successful? What are the downsides? Any advice or suggestions?
My mom who has dementia, as her dementia has progressed, has seemed to not recognize the need to urinate until she needs to go right away, which results in needing a quick trip to toilet. She wears depends bc she can't get there fast enough or if an aide is helping others right then. Taking her to the toilet on a schedule helps. Don't always ask if she needs to go, she might not realize it. Make it part of a transition, stop in the bathroom before lunch, or a walk, or a TV show.
My mom used pure wick, while in bed only in the hospital,. It was so so. Placement distressed her, and if not placed just right, it didn't work well. A bowel movement in the adult diaper/pull up made a mess, and I worried about uti.
One thing I ask you to consider is to widen your definition of "try" and " not try". As moms disease continues to progress, multi step procedures confuse her. Needing bathroom, finding bathroom, remove pants, underwear, sit down...etc. I find when I need mom to do something or ask her something, I need to break it down simply and do one step at a time, and wait for to do it or to respond. Then next step. It requires tremendous patience.
If you say you need to do this and this and this, ok. She may say OK, but only processed the first thing.
If she has a prolapsed bladder, frequent urinary infections, change her care over to a urologist as a routine. They at least will perform a real urinalysis, and not just a dipstick test.
Ask instead for physical therapy and kagels exercises.
Decrease caffeine and alcohol.
You may be able to manage symptoms of an overactive bladder with simple behavioral strategies, such as dietary changes, timed voiding and bladder-holding techniques using your pelvic floor muscles. Has she tried these?
https://jamanetwork.com/journals/jamasurgery/fullarticle/2672214
"Conclusions
Sacral neuromodulation is associated with a very high rate of failure, as measured by reinterventions, that occur at alarming rates within 5 years of placement. A device registry is urgently needed in this setting to advise stakeholders and assist future innovations."