Device That Helps Chronic Bladder Issues Available In Brick

BRICK, NJ — Many people have experienced that sensation of "my bladder is going to burst." For most, it's a one-time event, a response to drinking a lot of fluid on a particular day.

For those with chronic bladder issues, that sensation can be a persistent issue, one that sends them to the bathroom 25, 30 times a day, disrupting their sleep and, embarrassingly, causing incontinence that can range from dampened underpants to a full bladder release.

For others, those issues may force them to use a catheter to ensure their bladder empties on a regular basis to avoid serious health effects, including kidney damage or failure.

Those issues can be isolating. How do you spend time with friends if you need to go to the bathroom every hour, every half-hour? How can you go out for an evening if you know you'll need to be catheterized at some point?

A new treatment device approved in 2019 by the U.S. Food and Drug Administration offers relief for patients, and for those in the Shore area, a Brick Township urologist offers access to help people get back to active lives.

"People become a prisoner to their home," said Dr. Daniel Burzon, who is originally from New York but has been at the Shore for 23 years. "This treatment provides steady current going down the nerves. It's like replacing faulty wiring" to an appliance.

The device, Axonics Sacral Neuromodulation System, is an advancement over similar devices that have been in use for about 15 years, Burzon said, with a less invasive implant procedure and a smaller, rechargeable battery.

The advancements make the system life-changing for patients, Burzon said.

"It’s made my life much much easier," said Josephine Costas-Savallo of Berkeley Township. "I had to go to the bathroom constantly. People are looking at you like 'why do you have to go to the bathroom so much?' "

Josephine, 59, had tried several modifications to address her symptoms, including medication.

"The medication wasn't working," she said. "I was having accidents at night and going to the bathroom a lot during the day."

"It’s often like the smoke alarm is going off," Burzon said. "The nerves are telling the brain the bladder is full and the bladder is trying to respond to that. But the brain is sending a message to hold on, so the person can get to the bathroom. But the bladder isn't getting the message correctly," which leads to multiple trips even when the bladder isn't full, and accidents.

When her medication wasn't working, Burzon suggested the bladder stimulator, Josephine said.

"You first try to address it with behavior modification," Burzon said, having the patients eliminate caffeine and alcohol from their diets, as both can aggravate the problem. If that doesn't provide sufficient relief, there is medication that calms the bladder.

"But that gives horrendous side effects," Burzon said, including dry mouth. Beyond medication, there is pelvic floor therapy to tighten the muscles and try to regain control.

If none of those work, some people resort to Botox injections to the bladder, which paralyze the nerves. But that can be overdone, he said.

That's why Burzon offers his patients the sacral neuromodulation system.

It consists of a small wire lead that goes right under the skin near the nerves that control the bladder, a small implantable pulse generator, and a disc that is the recharging station for the rechargeable battery.

"It's a very tiny wire lead in the back," Burzon said.

To test to see if it's working, patients are asked to keep a journal of how many times they go to urinate for three days before it's implanted and for three days afterward, he said.

"Someone who has gone 25 times a day and had five leakage episodes will drop down to five to eight bathroom trips and one leakage," Burzon said.

The success during the test is often so dramatic the patients don't want him to remove the temporary leads, he said. The permanent device includes a battery the size of an SD card that sends continual energy to the nerves to make bladder contract and behave more naturally. It also includes a key fob that allows the patient adjust the settings to make sure it stays comfortable.

It takes less time for the doctor to implant the device — which is done in an outpatient setting with a local anesthetic, such as Novocaine — than it does for most people to get their hair cut, Burzon said.

"It allows people to sleep through the night if they’ve been awakened by the need to go to the bathroom," he said. That not only means a more restful sleep, but for women who are at increased risk of hip fractures the older they get, it eliminates the middle-of-the-night bathroom trips, with the risks of falling in the dark.

"Elderly women who fall and suffer a hip fracture have a 50 percent mortality rate," Burzon said. "If you can stop them from having to get up five times a night it’s a gamechanger for them."

Josephine said the procedure was simple, and the device isn't noticeable when you're wearing clothing.

"You can feel a slight stimulation. It's not painful at all," she said. Recharging it is simple and takes about half an hour every two weeks.

"They have me on a text reminder so I know when I have to charge it," she said. And every six months, Burzon finetunes the device for her.

"The setting is adjustable to what works for you," she said. "In the beginning you have more adjustments, and then it spaces out to every three-four months."

Burzon said the benefits are just as significant for someone who cannot urinate, such as someone with multiple sclerosis,

The device "takes over and causes the bladder to contract, replacing the need for catheterization," he said.

"For someone with multiple sclerosis, this is a gift to them," Burzon said. The bladder problems can lead to kidney failure.

The device is MRI-compatible, which is important for people who have multiple sclerosis and need frequent MRIs, he said.

"It gives them their lives back," Burzon said.

Sign up for Patch alerts and daily newsletters here, or download our app to have breaking news alerts sent right to your phone. Have a news tip? Email karen.wall@patch.com Follow Brick Patch on Facebook.