Medtronic InterStim® System for Urinary Control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments.

InterStim Therapy uses a small device to send mild electrical pulses to a nerve located in the lower back (just above the tailbone). This nerve, called the sacral nerve, influences the bladder and surrounding muscles that manage urinary function. The electrical stimulation may eliminate or reduce certain bladder control symptoms in some people. The system is surgically placed under the skin.

Dr. Razi has been performing this procedure both in the office and in the hospital for a number of years, with overwhelming success.

For more information, please visit:

• http://www.medtronic.com/patients/overactive-bladder/about-therapy/

Also referred to as “seed therapy” or a “prostate implant,” brachytherapy involves the insertion of a radioactive material, commonly referred to as a source, into the body. Attempts to treat prostate cancer by placing radioactive materials into the prostate date back to the early 20th century. However, the lack of a reliable way to ensure that the radioactive materials were placed in their desired locations limited the use of brachytherapy to treat prostate cancer. In the 1980s, a technique was developed using ultrasound to guide the placement of tiny radioactive “seeds” into the prostate. This technique was first made available in the United States in the late 1980s.

There are two approaches to brachytherapy for prostate cancer:

1. Low-dose rate (LDR) prostate brachytherapy. This is the most commonly performed technique. With LDR brachytherapy, the seeds are permanently placed into the prostate. The radiation is given off gradually over a period of months.
2. 

   Brachytherapy – Hospital Urological Procedure – Tracy and Manteca

   An ultrasound study may be performed prior to the day of the procedure to ensure there are no bones interfering with the placement of needles into the prostate. The ultrasound probe is placed into the rectum to obtain pictures of the prostate and surrounding structures. This study is commonly referred to as a transrectal ultrasound (TRUS). The information obtained from the TRUS can also be used to generate a road map for seed implantation. Ultrasound imaging is typically used to define the prostate although newer approaches using CT scan or MRI may be used.

The LDR seed implant procedure is performed under anesthesia. Radioactive seeds (which are smaller than a grain of rice) are loaded in individual needles that are passed into the prostate gland through the skin between the scrotum and anus. As the needles penetrate the prostate they are seen on a monitor and can be accurately guided to their predetermined position. Once the position of the needle in the prostate matches the intended position the needle is withdrawn leaving the seeds behind in the prostate. The radioactivity of the seeds slowly decays during the months after the operation, and there are few long-term risks associated with this treatment.

Alternatively, HDR brachytherapy may be utilized to place a highly radioactive source temporarily into the prostate. Hollow plastic tubes called catheters are pre-positioned in the prostate using a technique similar to LDR brachytherapy. The patient is then awakened and typically two or three treatments are given over the next several days after which the catheters are removed. A remote control device is used to move the radioactive material, which rests for a calculated period of time at various positions within each catheter. A computerized treatment-planning program is used to determine the required time the radioactive material must stay at each position and the sequential positioning of the radioactive material at each location needed to achieve coverage of the prostate with the prescribed radiation dose.

Dr. Razi is well versed in the latest care and treatment for all urologic oncology disorders.