Finding new help for a troublesome problem
One of the side effects of childbirth, diabetes, nerve disorders or trauma is fecal incontinence. Thanks to a device recently approved by the U.S. Food and Drug Administration, Houston surgeon Tal Raphaeli can help fix the problem.
Raphaeli, who has offices in Houston and Humble and performs this procedure out of Memorial Hermann Northeast Hospital, can implant the InterStim device in the sacral nerves near the tailbone.
“It’s an implantable neural stimulator that targets nerves in the lower spine,” Raphaeli said. “It’s like an implanted generator — like a pacemaker to control bowel movements.”
The sacral nerves help control the muscles related to bowel function. If the brain and sacral nerves don’t communicate correctly, the nerves will not tell the bowels to function properly. The InterStim device uses mild electrical pulses to stimulate the sacral nerves.
“It works with the brain, the nerves in the spine and the muscles in the sphincter area, but the interesting thing is no one knows exactly how it works or communicates between these areas,” Raphaeli said. “It was originally developed for urinary incontinence but was found that it helped bowel incontinence as well.” While the device has been approved by the FDA only this year, it has been in use for more than five years in the U.S. and in Europe.
The device is installed in two stages. First, the patient is outfitted with electrodes and an exterior power supply on their hip. This is worn for one to two weeks while the doctors figure out the best settings for the patient.
Next, doctors implant the device itself. Raphaeli said there is no time limit on the how long the device will work. It lasts as long as the batteries, and the batteries can be replaced and the device adjusted is necessary.
Raphaeli said the most common cause of fecal incontinence is obstetric injuries due to the effects of childbirth, whether through a difficult, prolonged birthing process or because of surgery necessary for the mother or the baby. Incontinence also results from diseases such as diabetes or from nerve disorders. Trauma from accidents also can cause fecal incontinence.
About Dr. Tal Raphaeli:
Tal Raphaeli is a board-certified general surgeon and is fellowship-trained in colon and rectal surgery. Raphaeli grew up in west Houston and attended St. John’s School prior to attending the University of Texas at Austin. He graduated from medical school at the University of Texas Medical Branch at Galveston and completed his general surgery training at Virginia Mason Medical Center in Seattle. He and his partner, Khawaja Azimuddin, operate Northwest Colon-Rectal Surgery with three branch offices: 1125 Cypress Station Drive, Houston; 20207 Chasewood Park Drive, Houston; and 9813 Memorial Blvd., Humble. The phone number for all three offices is 281-583-1300. They can also be reached on their website, www.colonsurgeonhouston.com.
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