Incontinence can often be the result of a miscommunication between the brain and the bladder and/or bowels. Sacral nerve stimulation (SNS) or sacral neuromodulation (SNM) therapy works to re-establish this very important communication channel. Incontinence Institute offers three implanted sacral neuromodulation devices:
What is a sacral neuromodulation device?
A sacral neuromodulation device is similar in size and function to a pacemaker, implanted just beneath the skin of the pelvis above the buttocks. This treatment is also known as sacral nerve stimulation (SNS). All three devices offered by Incontinence Institute emit tiny electrical pulses, which target an area near the sacral nerves to adjust or fine-tune neural activity controlling the bladder and bowels.
How does sacral nerve stimulation therapy work?
Sacral nerve stimulation therapy works by stimulating the sacral nerves with tiny electrical pulses. In individuals experiencing urinary or fecal incontinence, the brain and the sacral nerves don’t communicate properly. SNS therapy attempts to better regulate the sacral nerves’ function, so the nerves can interpret signals from the brain and pass them on to the surrounding pelvic floor muscles. This restores normal bladder and bowel function.
SNM devices are an option for patients who have not responded to more conservative treatments such as changes to diet, medication and physical therapy.
What’s the process for getting a sacral neuromodulation device?
Trial period and evaluation: The process begins with a two-week trial period employing a wearable, external version of the device to determine if the treatment is likely to be effective for a patient.
Surgery: If the trial produces positive results, the device is implanted in a patient’s lower back near the sacral nerves.
Post-surgery: After surgery, the doctor will program the device’s electrical signals based on the results from the trial period.
Learn more about the process for Axonics therapy and InterStim therapy.
How is an SNM device implanted?
The procedure to implant an SNM device can be quickly and safely performed at an outpatient surgery center through a minimally invasive surgery. This can often be done under local anesthesia, though some doctors will prefer to use general anesthesia. The device is inserted in the lower back, above the buttocks. The procedure itself typically takes between 20-30 minutes to complete.
Though insurance plans vary, Medicare and private insurance generally cover SNS treatment. Please consult with your doctor and insurance company.
What to Expect After the Device is Implanted
Most patients will notice some vague sensation in the sacral area. It should not be painful — if they are, contact your doctor. Most patients also report that they no longer notice the electrical impulses after a few weeks.
The goal is for SNS therapy to help patients return to normal activities without worrying about the risk of bladder or bowel leaks. A successful procedure should help patients be more confident of their ability to go through life and resume activities they were previously afraid to do because of bladder or fecal incontinence. Long walks, traveling or visits to a movie theater — things that can be difficult when patients are grappling with fecal or urinary incontinence — may now become a possibility for patients.
How do I program or manage an SNM device?
You’ll have a hand-held programming remote that allows you adjust or turn off the device if needed. Depending on your stimulation needs, your doctor may also set the device to turn on and off at regular intervals.
Will I be able to see the SNM device through my skin?
No, you will not be able to see the device through the skin once implanted.
Can the sacral neuromodulation device be removed?
Yes, the device can be removed. In the unlikely event that the procedure is not effective, it can easily be reversed.
Who is a good candidate for sacral neuromodulation therapy?
Sacral neuromodulation can be an excellent choice for patients who haven’t experienced success with more conservative treatments, specifically men and women suffering from the following conditions:
- Overactive bladder
- Urinary or bowel urge incontinence
- Non-obstructive urinary retention
- Chronic fecal incontinence
But it’s not ideal for all patients, including patients who:
- Lack the motor skills needed to operate the hand-held programming remote
- Are not good candidates for surgery
- Suffer primarily from stress incontinence
- Experience urinary retention due to benign prostatic hypertrophy (enlarged prostate)
- Cancer or urethral stricture
These therapies may also not be a good choice for patients who are pregnant, are under the age of 16 or who have neurological issues as a result of a chronic condition such as diabetes or multiple sclerosis, since the safety and effectiveness of the treatment has not been established in these populations.
If you’ve tried conservative approaches for your urinary or fecal incontinence and your symptoms still interfere with your activities of daily living, a sacral neuromodulation implant could be right for you. Contact our team of expert urinary and fecal incontinence doctors at our office in Nashville, TN.