NEwFOuND FREEDOM

Essentia Health OB/gyn uses implantable device to help women dealing with urinary incontinence

For three decades, Marcia Carlson planned her life around a bothersome nuisance – her urinary incontinence. She remembers getting caught in some unpleasant situations.

“I would do one errand and then come home,” said the 71-year-old retired Fargo schoolteacher. “I wore a pad for 30 years.”

Like many women, Carlson sought solutions for her urgency issues. Kegel exercises, biofeedback treatment and medication didn’t help much. Then she drove a friend to a doctor’s appointment. Her friend was considering an implantable device called “Interstim” that helps patients with an overactive bladder.

Carlson had always been wary of surgery, but decided she needed to explore this option. “I thought, ‘Oh, just go for it. You can’t live this way anymore,’” she said.

Dr. Stefanie Gefroh Ellison, an obstetrician and gynecologist at Essentia Health-Fargo, implanted Carlson’s Interstim device last spring. “It was in April on Friday the 13th,” Carlson joked. “It turned out to be my lucky day.”

Often called a “pacemaker for the bladder,” the small device improves the communication in the nerves between the bladder and the brain. Women with urge incontinence feel a strong need to go to the bathroom before the bladder is full. The Interstim device helps the bladder to fill up more appropriately, allowing the patient to urinate less frequently. It also helps to eliminate the sudden urges to go.

Dr. Gefroh Ellison has implanted the device in women in their 30s all the way to their 80s, with positive results.

“Interstim is not the first line of treatment for incontinence or urgency issues,” Dr. Gefroh Ellison explained. “It’s good for people who have tried behavioral changes, biofeedback and medications. If they are still not where they would like to be with their lifestyle and staying dry, Interstim is a good option.”

Interstim is also not intended for women with stress incontinence – the leaking that can occur when someone coughs or sneezes.

Before receiving the permanent implant, patients undergo a quick office procedure to test whether the device would make a difference.

The electrodes are placed temporarily, and patients wear an external monitor.

“I tell them they have nothing to lose to try it out for a couple of days,” Dr. Gefroh Ellison said. If patients experience at least a 50 percent improvement in their symptoms, they’re candidates for the implant.

The surgery is performed at Essentia Health-Fargo on an outpatient basis, allowing patients to go home the same day. The implant goes into the fatty tissue of the buttock and doesn’t cause any discomfort when sitting or lying down. Dr. Gefroh Ellison uses X-ray imaging to pinpoint the electrode placement during the procedure, which typically takes an hour or less.

Dr. Gefroh Ellison can never guarantee that a patient will be completely dry as a result of the implant, but she said it can make a big impact on a patient’s life. “Women can sleep better and can go to social activities without always having to know where the bathroom is,” she said. “We hope we can eliminate part of the fear they have with social situations.”

Carlson has been very pleased with her results. “I have the freedom to be able to go places and do things and not be so worried about it,” she said. Carlson plans to fly to visit a friend in Palm Springs, Calif., something she couldn’t imagine doing before getting the Interstim implant.

Carlson’s also spreading the word about the procedure to her friends. She asked Dr. Gefroh Ellison to speak to a group of retired Fargo schoolteachers last fall. “I thought this was really important for other women to hear,” Carlson said. “It’s amazing – there are a lot of people who haven’t heard about it.”

Dr. Gefroh Ellison welcomes the chance to discuss this sensitive topic with women.

“All of us know women who have really struggled with incontinence. We’ve seen how it can really isolate someone. They don’t want to talk about it, and they’re afraid to go out,” she said. “I work hard to make my office a safe place to come and talk about it, and hopefully, get some relief.”

Writer: lonna Whiting | photography: josh leClair

adie and Jon Erickson’s home in a quiet, wooded area of north Fargo is the perfect place for hiking and biking.

But nothing compares to canoe season for this outdoorsy couple. They’re ready for some northern Minnesota camping.

“Anything outside and we’re there,” Sadie said, 32.

This year, the loving couple won’t be swatting mosquitoes by the campfire alone. They welcomed fraternal twins Liv and Hadley four months ago.

“We knew we wanted to be parents from the minute we became a couple,” Jon said, 33. “And deep down I always wanted twins. But when it came time to start trying, it wasn’t so easy for us.”

Sadie has a history of ovarian cancer which contributed to fertility issues. “We trusted our instincts and decided to get help,” Sadie said. Their journey to parenthood first took them to Sanford’s Reproductive Medicine Clinic where the team of board-certified physicians, including Dr. Stephanie Dahl, helped them get pregnant.

When they received the good news from Dr. Dahl, Sadie explained that Dr. Dahl was almost more excited than she was. “It just goes to show the personal relationships we made. From the nurses, the lab techs, everyone, they were just amazing,” Sadie said.

Although Jon and Sadie got what they wished, they were indeed expecting twins, Sadie and the babies would need close monitoring throughout the pregnancy, during the delivery and after birth.

Dr. Peter Van Eerden, North Dakota’s only board-certified maternal-fetal medicine physician, along with the couple’s OB/GYN Dr. Rebekah Tomkins, teamed up to provide Sadie and the babies with the most intensive, comprehensive care available to women with high-risk pregnancies.

Dr. Van Eerden and his team monitored Sadie and the babies through ultrasounds looking at the babies’ anatomies, a fetal echocardiogram to look at the babies’ hearts and anti-partum fetal testing in Sadie’s third trimester twice a week to make sure there were no signs of complications.