Bowel and urinary incontinence affect around 8% of Americans during their lifetime. Although most respond to conservative treatment, some do not. This has necessitated the invention of other treatment modalities for such cases. This includes sacral nerve stimulation. One of the common sacral nerve stimulation modalities is Axonics therapy. If this is new to you, herein is a guide to what it is and the possible side effects of Axonics.
What is Axonics Therapy?
Axonics implant is one of the modalities of sacral nerve stimulation used to treat urinary retention, and fecal and urinary incontinence. The therapy is clinically proven and approved for use in the USA by the FDA.
Axonics therapy is used in the management of the following urinary and bowel symptoms:
- Overactive bladder: an urgent urge to urinate that may cause urine leakage or unbearable frequency.
- Urinary frequency: refers to eight or more urination episodes in a day.
- Fecal or bowel incontinence: a sudden urge to pass stool that can’t be controlled. It always results in involuntary leakage of stool before reaching the toilet.
- Non-obstructive urinary retention
- Urinary urgency incontinence: is an urgent need to pass urine with trouble holding the urine before making your way to the toilet.
However, not everyone with these disorders is eligible for Axonics therapy. Axonics implants are recommended for individuals who fail to respond to other treatment modalities like diet modification, medical therapy, and surgery.
It can also be used in people adversely affected by medical treatment.
Of note is that Axonics therapy is not recommended in the following situations:
- Stress incontinence
- During pregnancy
- People with neurological diseases such as multiple sclerosis and diabetes mellitus
- In urinary obstruction due to prostate cancer and enlargement, urethral stricture or external compression of the urinary system by an extrinsic mass
- In pediatrics (individuals below 16 years old)
What to Expect From Axonics Implant Procedure
The procedure is done to insert a stimulator into the skin of the buttock. The function of the stimulator is to promote communication between the central nervous system and the sacral nerves, which control bladder and bowel function.
It is usually a minor surgical procedure in two phases; the trial phase and the permanent phase. The essence of the trial phase is to enable the surgeon to predict long-term therapy’s benefits.
During the trial phase, the doctor will insert a temporary device in the skin of the upper buttock, which will be required to remain in place for 2-4 weeks. During this period, you will record bowel and bladder activity. From this track, the doctor can gauge your suitability for long-term therapy.
Suppose there is an improvement in symptoms’ severity, you will likely respond to long-term therapy. Thus, at the end of this period, you will undergo another procedure to insert a permanent device.
The Axonics implant device is tiny with the following dimensions:
- 6 mm thick
- 22 mm width
- 42 mm long
The Axonics therapy device insertion procedure is done under local anesthesia. It is an outpatient procedure; thus, you will return home that day. In addition, it is a short procedure not exceeding an hour in experienced hands.
The implant is meant to give you 15-year symptom relief. However, recovery from the procedure may take weeks to months to heal fully. After 15 years, the device should be removed and a new one inserted.
Of note is that the device can be stopped or removed at any time. Therefore, if you feel it is the cause of a troublesome symptom, it can be removed easily without causing significant damage to the skin and nerves.
If there is no improvement during these few weeks, then you are unlikely to respond to therapy; thus, the Axonics implant device will be removed. In such a case, your doctor will not insert a permanent device. In addition, he will recommend another treatment option.
Lastly, you must maintain a high hygiene standard on the procedure site. This not only prevents infection but also promotes healing. This is especially important during the initial weeks of the procedure.
Axonics Side Effects
FDA approves Axonics therapy; thus, it is very safe. There are no severe side effects except for mild discomfort associated with stimulation.
Just like any other surgical procedure, you may experience some localized swelling that resolves quickly, thus should be a point of concern.
Some people may also experience a change in sensation. It mainly occurs in the buttock and feet due to stimulation by the Axonics implants. These sensations may be perceived as an increased sensation or ‘tinglings’. In addition, there have been cases of mild numbness, which resolve with time.
Previously, there were some cases of infection in the minor surgery procedure. Fortunately, it is rarely seen since aseptic techniques are widely practiced.
The other issues that people with Axonics implants rarely complain of include:
- Heat at the site or feet
- Bleeding and hematoma may occur, but the body quickly resorbs it.
- Device erosion or migration
- Technical malfunction of Axonics implants
- Transient tingling sensations
- Unintended nerve stimulation that may lead to undesired bladder or bowel function
According to patients’ reviews, more than 92% agree that it is an effective system for treating bowel incontinence, urinary incontinence, overactive bladder, and urine retention. In addition, they agree that the devices are easy to use. 91% found charging the devices easy. In addition, 94% found charging time acceptable.
Another 94% found the Axonics therapy outcomes satisfactory, while 93% accepted that they could choose the therapy in the future.
Other Considerations When Using Axonics
When using Axonics, ensure that you have the indications. In addition, ensure they are prescribed by an experienced doctor, preferably a surgery consultant.
Of note is the effectiveness and safety of Axonics therapy are not documented for use in pregnancy. Thus, we aren’t sure how it may affect an unborn baby. For this reason, you shouldn’t use it during pregnancy.
Moreover, Axonics therapy is not beneficial in urinary or bowel symptoms due to obstruction by prostate enlargement, cancer, and other causes of mechanical urinary obstruction. Additionally, it is not helpful in multiple sclerosis and diabetes mellitus.
In summary, Axonics therapy is a safe treatment modality with only minor side effects that resolve with time. If you have any questions on Axonics therapy, please contact our medical concierge.