What is Sacral Nerve Stimulation (SNS)?

Sacral nerve stimulation (SNS), also called sacral neuromodulation, is a treatment for bladder and bowel problems. Using thin, insulated wires (electrodes) and a device called a neurostimulator, sacral nerve stimulation can deliver electrical signals to correct communication issues between the brain and the bladder. The electrical signals reach the sacral nerve, which is responsible for muscles that control the bladder and rectal sphincter. By targeting this nerve, sacral nerve stimulation can influence the activity of pelvic muscles to treat overactive bladder, fecal (bowel) incontinence, and chronic constipation. When diet or lifestyle changes, medication, and other conservative options fail to work, neurostimulation is an option.

SNS surgery has two parts. The first part is an evaluation phase, during which it will be determined if neurostimulation will be an effective treatment option for you. You will be lying on your stomach while a temporary electrode lead, through which electrical signals will travel, is inserted into your lower back. A permanent lead may also be used, and it would remain in place should the trial period prove successful. The lead is connected to an external neurostimulator. The procedure takes approximately one hour and may be performed in a doctor's office, hospital, or surgical center. After your procedure, you will be required to keep a log of your toilet habits over approximately two weeks, and you may need to limit your activities during this time. If your symptoms do not improve after the trial, you may repeat the test phase or discuss other treatment options with your doctor.

If the trial stimulator is effective, you will undergo the second phase of SNS surgery, which is permanent implantation. In the second stage of surgery, the temporary lead (if used) will be replaced with a permanent lead. Then the sacral nerve stimulator will be implanted subcutaneously (under the skin) in the upper buttock. You should be able to return home the day of your procedure.

If you are sore after surgery, your doctor may give you medication. The sacral nerve stimulator will be programmed after your procedure, and when it is turned on, you should feel a sensation similar to pulling, tapping, tingling, or pulsing. You will need to work with your doctor during follow-up appointments to determine the most effective settings for the stimulator. You will be given instructions on how to adjust it yourself at home. The stimulator is powered by a battery that will last approximately five years, after which it can be replaced.

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