1. Initial Office Evaluation for OAB
Urinary Incontinence, Urgency, Frequency& Nocturia
Conservative Treatments
Fluid & Irritant Reduction, Timed Voiding, Physical Therapy
eCoin Placement
1st Line Trial of TENS Therapy or Oral Medication Samples
TENS Unit for 1 week twice a day for 30 minutes: No Side Effects
Beta Agonist for 4 Weeks  Rare Side Effects: HTN, Headaches
Anticholinergic for 2 weeks  Common Side Effects: Dry Mouth, Dry Eyes, Constipation
Re-Evaluation in the Office
Assess Experience and change in Bladder Symptoms
Decide on Therapy Plan
*eCoin Tibial Implant*
20 minute procedure to implant a nickel sized device at the ankle
Automatically stimulates the tibial nerve for bladder control
Device exchanged after 3 to 5 years of therapy
Urgent PC Therapy
Clinic Treatment
12 Weekly Visits
30 Minute Sessions at Ankle
InterStim Lead Surgery
2 Part Outpatient Surgery
2 Week Sacral Stimulation trial
Botox Injection
Clinic Procedure
Cystoscopic needle delivery
Retention and UTI risk
Discomfort with Injections
Pacemaker Placement
Hardware placed at buttock
Battery lasts about 5 to 7 years
Surgical exchange
Management of device remote
No MRIs below the neck
Maintenance Treatments
30 minute sessions monthly
Time Consuming
Repeat Procedures
Usually every 6 to 11 months