Sacral neuromodulation (SNM) uses an implanted device to send mild electrical impulses to the sacral nerves. Located in your lower back/buttocks, the sacral nerves control the muscles used for bladder and bowel function. Stimulating these nerves helps restore normal control of these muscles. Sacral neuromodulation is sometimes called sacral nerve stimulation (SNS).
Because the nerves control both bowel and bladder function, SNM can be used for many conditions, including:
Our urogynecology and pelvic surgery program is the region’s only Axonics Center of Excellence. This designation goes to programs with the highest level of expertise in using sacral modulation to treat bladder and bowel dysfunction.
Sacral neuromodulation is done in 2 stages: Stage 1 typically is performed in the office, and stage 2 under general anesthesia in an operating room.
Stage I (lead placement and testing phase): The first stage involves inserting an electrode (lead) through the lower back. They will test the lead to ensure the proper muscle responses happen. The lead then is connected to a device outside your body that sends electrical impulses. Over the next 5 days, the device will be adjusted until you get the desired effects.
Stage 2 (permanent neuromodulator/battery placement): Once you see improvement in symptoms of more than 50%, you will have another operation to put in the permanent neuromodulator/battery. It goes in your body through a small incision above your glutes (bottom).
After your first visit to the doctor to discuss SNM, you may be asked to undergo some bladder testing (urodynamics), and you will fill out a bladder diary or bowel diary. Before surgery, you will have a preoperative (preop) visit and some basic lab work. If you need surgical clearance, you will be asked to get this before surgery.
You will have a small incision on your back and your bottom. Both stages are outpatient procedures, so you will not need to stay overnight at the hospital.
Overall recovery time is usually 6 weeks with some activity restrictions. Many patients can return to a normal routine shortly after surgery. Restrictions include:
Complications from SNM are uncommon, but talk to your doctor about possible risks, including:
Other risks specifically for SNM include:
With typical use, the battery lasts for about 15 to 20+ years. However, if you feel like you are continually increasing the power on the device before battery life is up, the doctor will need to check the battery and see if it has died or if there are any mechanical issues.
Axonic is the company that makes the implant. When you receive your implant, you will receive contact information for an Axonic representative. If you need an MRI in the future, you should contact your personal Axonic representative to adjust the implant settings before the MRI so it will be safe.
Also, metal detectors and equipment such as airport screeners might affect the implanted device. You will be issued an identification card saying that you have an implanted device and should be allowed to bypass the metal detector. If you need to pass through the metal detector, we recommend turning the device off before going through and turning it back on after.
Check your insurance plan benefits to see if your policy covers sacral neuromodulation (SNM). If it does, our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier.