Factors Your Doctor May Consider – Sacral Neuromodulation

Your doctor will help you to determine if sacral neuromodulation is right for you. This treatment is designed to reduce bladder control problems for people who suffer from overactive bladder, including unexpected small or large leaks, or the need to use the bathroom very frequently.

Sacral neuromodulation may be an option for people who have failed or could not tolerate other treatments.

Trial Assessment

The potential benefit of sacral neuromodulation for you can be demonstrated with a trial assessment. This procedure uses an external stimulator and test lead system that can be placed during a procedure in theatre.

Throughout the trial assessment period, you will keep track of your bladder symptoms in a special diary. If your symptoms are significantly reduced or eliminated during the testing period, you may benefit from long-term use of sacral neuromodulation.
 

Will It Eliminate Your Symptoms?

 The results of sacral neuromodulation vary from person to person. This treatment option is not a cure for bladder control problems but it may help relieve your symptoms.

Next: The Trial Assessment

The Trial Assessment

The trial assessment takes 3 to 7 days and lets you try neuromodulation to see if it is right for you without making a long-term commitment.

Your doctor will help you determine whether neuromodulation is right for you. The treatment is designed to minimize the symptoms of overactive bladder. Neuromodulation may be a good option for you if you have not had success with or could not tolerate more conservative treatments.

Here’s how it works:

During the procedure, your doctor will numb a small area and insert a thin, flexible wire near your sacral nerves (near your tailbone). The wire is taped to your skin and connected to a small stimulator which you’ll wear on your waistband.

The stimulator sends mild electrical pulses through the wire to a sacral nerve. The stimulation may help improve your bladder function or get it working the way it’s supposed to.

During the trial assessment, you can continue many of your daily activities with caution. You can usually continue to work throughout your trial assessment if your job doesn’t require strenuous movement.

You’ll be asked to document your urinary symptoms. If your symptoms are significantly reduced or eliminated during the trial, you and your doctor can discuss long-term neuromodulation therapy.

Your doctor or nurse will give you information about operating the test stimulator. He or she will also tell you about any precautions or activity restrictions related to the trial assessment.

The results of neuromodulation vary from person to person. This treatment option is not a cure for bladder control problems; it may help relieve your symptoms.

Next: Your Healthcare Team

Your Healthcare Team

As you begin the diagnosis and treatment of overactive bladder, you may meet a variety of medical professionals dedicated to giving you their best possible care. It’s important to be honest and straightforward with your health care providers about your symptoms, lifestyle, and treatment concerns.

Urologist

Urologists are surgeons who specialise in diseases of the male and female urinary tract and the male reproductive organs. Some urologists have specific experience in female urology and the treatment of incontinence.

Gynaecologist

Gynaecologists specialise in women's general health, including care of reproductive organs, breasts, sexual function, and hormonal disorders. Gynaecologists also treat pelvic organ and urinary tract problems.

Urogynaecologist

Urogynaecologists specialise in diseases of the female urinary tract and pelvic reconstructive surgery. They also treat prolapse and bladder control problems, including incontinence.

Urodynamics Nurse

Urodynamic tests are usually conducted by nurses specialising in urodynamics. The test is a diagnostic procedure used to evaluate your bladder function. The results of these tests help your doctor decide which treatment is right for you.

Nurse, Nurse Practitioner or Physician Assistant

A nurse, nurse practitioner or physician assistant typically works closely with your doctor. He or she may answer questions, and advise you on treatments such as Kegel exercises, fluid and diet modification, or physiotherapy.

Physiotherapist

Your doctor may prescribe physiotherapy to strengthen the muscles in your pelvic floor. Pelvic floor rehabilitation may include pelvic floor stimulation and biofeedback-guided pelvic floor exercises, used alone or in combination.

Next: Surgery – What to Expect

Surgery: What to Expect – Implanting the Neurostimulator

Before the Procedure

Patient instructions differ among doctors. It’s important to follow all your doctor's instructions carefully.

After the Procedure

You may need to restrict your activities immediately after surgery. Talk to your doctor about what is appropriate for you.

Next: Q&A Getting Sacral Neuromodulation

Questions and Answers – Trial Assessment

• Will my everyday activities be affected during the trial assessment?
• Will the trial assessment cure my condition?
• What does the stimulation feel like?
• If my trial assessment is successful, what is long-term neuromodulation therapy?

Will my everyday activities be affected during the trial assessment?

You should take it easy during the trial assessment period. Avoid bending, stretching, or lifting heavy objects. You can usually continue to work throughout your trial assessment if your job doesn’t require strenuous movement. Be aware that the trial assessment wire can move. Keep your activity level low to moderate.

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Will the trial assessment cure my condition?

No. The trial assessment is temporary. It is a tool that helps determine whether neuromodulation is appropriate for you. Once the wire is removed, your original symptoms will return. If you have had positive results with the trial assessment, then you and your doctor may decide to use long-term neuromodulation to treat your symptoms.

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What does the stimulation feel like?

Stimulation varies from person to person, but most people describe it as a slight “pulling” or a “tingling” sensation in the pelvic area. It should not be painful. Talk to your doctor if you have any concerns.

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If my trial assessment is successful, what is long-term neuromodulation therapy?

With long-term neuromodulation, a device is implanted during an in-patient procedure.

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Living With Neuromodulation