Axonics vs InterStim

Millions of Americans and people worldwide suffer from urinary and bowel incontinence. These medical problems can have a negative social, emotional, and psychological effect on an individual’s life. The patient cannot afford to be away from a washroom, and performing everyday activities becomes a challenge.

Usher in the good news.

Through either Axonics or InterStim Sacral Nerve Stimulation, you can bid farewell to fecal and urinary incontinence symptoms. We see you wondering, “What are these technologies, their similarities, and differences?”

We are here to answer all your questions and help you make the right choice. Read on:

What is Sacral Nerve Stimulation?

Sacral Nerve Stimulation (SNS) is a surgical procedure that involves stimulating sacral nerves by implanting a low-voltage device beneath the pelvis skin above your buttocks. It can be performed by Axonics or InterStim therapy. 

Your sacral nerve (found at your spine’s base) affects how your bladder, pelvic floor, and bowel function. The implanted pacemaker-like device stimulates this nerve to help manage urinary or fecal incontinence. 

SNS can be effective even in cases where conservative treatment methods have failed to achieve desirable results. Patients with the following conditions can benefit from it:

  • Severe fecal incontinence
  • Urinary incontinence
  • Overactive bladder
  • Non-obstructive urinary retention
  • Urgency-frequency

However, the procedure isn’t ideal for patients who:

  • Don’t have the motor skills needed to hold the programming remote
  • Experience urinary retention because of enlarged prostate 
  • Cannot undergo surgery
  • Experience stress incontinence
  • Suffer from cancer or urethral stricture 

The treatment’s effectiveness and safety haven’t been established among pregnant women, children aged 16 years and below, and patients with neurological problems. 

Axonics vs InterStim

Both Axonics and InterStim Therapy function in a similar way. The key differences only occur in their devices.

What is Axonics Therapy?

Axonics is an SNS procedure that helps treat urinary incontinence, fecal incontinence, and leaks. September 2019 saw Axonics gaining FDA approval. And its latest generation (the third one so far) has a more reduced recharging needs and allows you to control your device remotely. 

What is an Interstim Implant?

Interstim implant acts the same way as Axonics but tends to differ in size and charging needs. Since 1997, these devices have been helping individuals with urinary incontinence. 

And it gained FDA approval for bowel incontinence treatment in 2011. More than 100k patients have benefited from it so far.  Currently, there are two types of InterStim: InterStim II and InterStim Micro. 

Key Similarities

These technologies’ working principles and procedures are similar:

1. How They Work

Both procedures employ low-voltage electrical pulses to stimulate the sacral nerves. 

If you suffer from fecal or urinary incontinence, your sacral nerves aren’t communicating well with your brain. The result is poor (or nil) interpretation and transference of signals to the surrounding pelvic floor. 

Using either InterStim or Axonomics SNS can restore proper signaling, stopping leaks and frequent (or sudden) urges to visit the washroom. 

2. Procedures

Both Axonics therapy and InterStim implant involve similar procedures: 

Therapy Trial

The therapy involves a minimally invasive procedure where an external trial device is used to stimulate the actual implanted one. The period lasts up to two weeks to ascertain whether a permanent device will be effective. 


If you successfully sail through the trial period, your doctor can implant the device near the sacral nerves. The 20-30 minute procedure is usually minimally invasive and is done at an outpatient facility. In most cases, the doctor will use local anesthesia. 

Generally, private and Medicare policies can cover both procedures. Your best bet is to consult your physician and insurer to confirm the insurance options.


After successful implantation, your physician will program the device’s signals per the trial’s outcomes. For example, they may set the hand-held programming device to switch off or lower the signal if necessary. You can also do the programming manually. 

Visibility of Implanted Device

The implanted devices aren’t visible through your skin. But in case of failure, both procedures are easily reversible. 

Do you have another medical condition that requires Magnetic Resonance Imaging (MRI)? You can go ahead with the screening even if you have Axonics or InterStim implants.  

Length of the recovery period

After a few days, you can conduct light duties without any fear. And expect to spring back to your usual daily routines within 21 days.

Axonics vs InterStim: Key Differences

Let’s now walk through their differences: 


The technologies’ devices differ in size, charging needs, and replacement requirements. 

InterStim II

  • It measures 44 mm by 51 mm 
  • Recharging isn’t required
  • Requires replacement after five years

InterStim Micro

  • It’s the smallest SNS device, measuring 17 mm by 47 mm
  • It needs 20-minute charging after about 7 days
  • You have to replace it after 15 years

Axonics Therapy

  • It measures 23 mm by 45 mm
  • It needs 1-hour wireless charging per month
  • Requires replacement after 15 years

Effectiveness for Bowel Incontinence

According to a study involving 120 patients, here are the InterStim surgery’s results:


  • About 50% recovered from the issue totally
  • 30% reported a 50%+ reduction in bowel leaks
  • 80%+ experienced notable positive outcomes


ARTISAN-SNM research found that:

  • The procedure reduced up to 51% of bowel incontinence symptoms
  • 91% of patients experienced positive results and satisfaction

Effectiveness for urinary incontinence


Studies published in Urology and Medtronic Journal reveal the following:

  • 82% of overactive bladder patients gained positive results after 5 years
  • 59% of urge incontinent patients reported a leak reduction of 50+%/day 
  • 45% of patients noticed the absence of incontinence issues after 5 years
  • 56% of patients with high urge frequency achieved at least 50% in volume emptied and lower frequency of urgency


The ARTISAN-SNM revealed that 93% of individuals reported satisfaction. And after 1 year, they experienced

  • 75% overall reduction in this issue
  • 88% average reduction in leaks/day
  • 74% experienced a complete reduction in large leaks

Live Confidently

If more conservative treatment approaches haven’t solved your incontinence issues, Sacral Nerve Stimulation can be your much-needed savior. 

And choosing between InterStim and Axonics doesn’t have to be an extra headache. These two methods are similar in most areas, except for device sizes and requirements. Additionally, studies have proved that they’re both effective. Are you still having doubts? The Incontinence Institute will clear them. Contact us today and start your journey towards an incontinence-free life.

About The Incontinence Institute

At the Incontinence Institute, our team of healthcare providers understand the physical and mental trials that accompany living with urinary or bowel incontinence. Because of this, we are sensitive to your situation and treat all of our patients with the utmost respect and concern for discretion.

Individual incontinence conditions, treatment and recovery times may vary. Each patient's experience with incontinence procedures and / or surgery will differ. All surgical procedures involve some level of risk. If directed to pursue surgery by your physician, prompt action is advised, as waiting may reduce the efficacy of surgical treatment. The opinions expressed in patient testimonials are by patients only; they are not qualified medical professionals. These opinions should not be relied upon as, or in place of, the medical advice of a licensed doctor, etc.

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Incontinence Institute 2009 Mallory Lane, Suite 100 Franklin, Tennessee 37067