InitialOfficeEvaluationUrinaryIncontinence,Urgency,Frequency,Nocturia

MonthlyMaintenanceTherapy

AlexRogers,MDSansumClinicUrology

4151FoothillRoadSantaBarbara,CA93110• Phone:805-681-7564

OutpatientSurgery1to2weekTrial

InterStimLeadProcedureUrgentPCTherapyClinicTreatment

12Weeklyvisitsfor30Minutesessions

BotoxTreatmentClinicProcedure

CystoscopicNeedleInjection5%RetentionRate

Symptomsshouldimprove>50%withconservativetreatmentsormeds.

Ifyouexperience<50%improvementinsymptomsyoushouldconsiderothertreatmentoptionsbelow.

Re-EvaluationintheOffice

TrialofaMedicationSampleBetaAgonistfor4weeksàRareSideEffects:HTN,HeadachesAntiCholinergicfor2weeksàCommonSideEffects:DryMouth,DryEyes,Constipation

ConservativeTreatments

Fluid&IrritantReduction,TimedVoiding,PhysicalTherapy

5to7YearBatteryLife

InterStimPacemakerPlacement

RepeatTreatmentsUsuallyevery6to11months

***eCoinAnkleDevice***FDAapprovedstudyinvolvingaproceduretoimplantanickelsizeddeviceattheanklewhichstimulatesthetibialnerveforimprovedbladdercontrol

eCoinPlacement

eCoin device for Overactive Bladder Treatment Overactive bladder involves the symptoms of urgency, frequency, urge incontinence, and nocturia. It often lowers quality of life. Overactive bladder affects 16% of adults, yet most of this group continues to suffer from bothersome symptoms.

eCoin is a fully-implantable, radically small device that is implanted in the lower leg where it stimulates the tibial nerve.Stimulation of afferent tibial nerve fibers causes an inhibition of the micturition pathway in the spinal cord. From there, either the pelvic or the pudendal or both nerves act on the bladder to inhibit overactivity. Interestingly, the same spinal roots (L4-S3) are targeted by sacral nerve stimulation (SNS) but the response to SNS is acute and thus its mechanism is somewhat distinct.

eCoin is a nickel-sized device which offers an alternative option for bladder control as demonstrated by the below diagram which explains the shortcomings of our current overactive bladder therapies.

Sansum Clinic is Participating in a Study for Overactive Bladder with the eCoin A new treatment for overactive bladder is being tested, and Sansum Clinic will be one of twenty centers in the United States offering it to patients. A study has been approved by the FDA to study the effectiveness of an electroceutical coin (eCoin) in treating overactive bladder and urgency incontinence in women and men.

Dr Alexandra Rogers, MD is part of the voiding dysfunction specialists who will implant 120 devices as part of the six-month study. We are excited for Santa Barbara, California to be on the forefront of innovative, advanced treatment along with major health institutions across the country. We are looking forward to offering our patients a new treatment developed for a chronic condition that significantly impacts quality of life.

The eCoin will potentially eclipse the three current third line treatment options which include posterior tibial nerve stimulation (i.e. Urgent PC), sacral nerve stimulation (i.e. Interstim) and chemodenervation bladder injections (i.e. Botox). In addition the device is delivered with the convenience of a one-time procedure making it more convenient than PTNS and less invasive than both Botox and Interstim.

PTNS is a clinic treatment that uses a needle to stimulate the tibial nerve, but requires a commitment of 30 minutes of stimulation once a week for 12 weeks and monthly thereafter. Botox bladder injections require retreatment with a cystoscopy procedure on average every 6 to 11 months. Interstim is a procedure that implants a stimulating device near the sacral nerves in the lower back, but involves two outpatient surgeries.

We are thrilled to deliver this innovative therapy to our patients. There is great potential for providing efficacy with this innovative eCoin device.

Qualified individuals who may be interested in participating in this cutting edge study at no cost can contact Sansum Clinic Urology at (805) 681-7564.