Overview
Sacral neuromodulation is a treatment for urinary urge incontinence, urinary frequency and urinary retention. It is an implantable device that delivers low amplitude pulse stimulation to one of the nerves in the bladder.
Procedural Details
The procedure is performed in two outpatient stages. During the first stage, a small fiber is placed next to the nerve through the skin in your back. X-ray is used to localize the exact position of the nerve before placement. You will feel a tapping or vibration in the bladder, urethra, vagina and rectum when the fiber is implanted properly.
The second stage is done one to three weeks later. During this stage, the fiber is connected to a temporary external generator that looks like a pager or cell phone. You will keep a bladder diary record of the number of voids, urine loss, voided volumes and catheterized volumes.
If the stimulation device has improved symptoms by 50 percent or better, a permanent generator is connected to the fiber and implanted beneath the skin in the buttock or hip.
Watch a video on Female Urinary Incontinence at UWTV
Medications
Medications for sacral neuromodulation
- Detrol
- Ditropan
- Enablex
- Vesicare
- Botox bladder injection
Considerations
Any patient who has used several medications to treat urinary urge incontinence without success is a candidate for this procedure. Any person who needs to catheterize to empty the bladder is a candidate.
Effectiveness
Up to 85 percent of patient who have urgency, frequency, or urge incontinence, and 77 percent of patients who have urinary retention will have a 50 percent or better improvement in symptoms.
Risks
Risks after sacral neuromodulation include infection, bleeding, pain and failure to correct symptoms.