Sacral neuromodulation explained
What is sacral neuromodulation and who is it for?
Sacral neuromodulation procedure
Once you have decided to have sacral neuromodulation a procedure is booked for you to have the ‘test lead’ placed.
A thin electrical lead is placed to the sacral nerves. The procedure is short – approx 40-60 mins and you will need to have a general anaesthetic.
You will wake up from the procedure and you will be instructed how to use the device. You will have two small cuts on the lower back and the lead will exit one of those small cuts and be attached to an outside programmer which you wear on a belt.
When the device is on, you will feel a sensation in the undercarriage. You should not feel pain. Different programmes will be saved on the device and you can adjust between them. You will have to clean yourself with wet towels for the test period as we do not want water getting into the dressing.
During the test period, you should not do any strenuous exercise or activity.
When reviewed after the test period (2-4 weeks) you will be asked to do a bladder diary before your appointment. This is very important as it allows Dr Kong to assess the success of your test phase.
If the procedure is deemed successful a second operation to insert the implantable pulse generator (IPG) under the skin is performed. The test lead remains in place and is connected to the IPG. Both procedures require a general anaesthetic.
After the second procedure, Dr Kong will usually see patients a few weeks later to assess wounds and see how your treatment is going.
Usually, if you are happy with the results Dr Kong will see you again at 3 months and then every 6- 12 months.
Recently MRI compatible devices have been approved for use in Australia. Patients can opt for a battery that is changed once it runs out (5-7yrs) or one that is rechargeable.
The lead is a thin wire and the programmable device is the size of a stopwatch and weighs less than 60g
Many patients who opt for sacral neuromodulation have tried other alternatives of conservative management, medication or botox into the bladder.
There are also last resort options of permanent catheter drainage and bigger operations to divert urine away or increase bladder storage ability.
Sacral neuromodulation risks
Risks and side effects: what should I know?
As with all operations, the procedure carries general risks of anaesthetic and reactions to medication.
Specific risks to the operation include:
- Movement of the lead
- Pain at the site of insertion
- Failure of the device to help your problem
Long-term risks include:
- Device failure
- Migration of the lead
- Battery failure which usually will need to be changed at 5-7yrs ( this requires a procedure similar to the second one where the battery is just changed)
Yes but it is uncommon.
Strong electromagnetic fields such as those used in some door security and airport security scanners can turn your device off. It is a good idea to carry your device information in your wallet and show security staff. Look out for signs that inform you to report to staff if you have a cardiac pacemaker, this will apply to you. Turn off your stimulator before you enter these scanners to avoid problems.
Perth urologist for sacral neuromodulation
Why Dr Kong?
Dr Kong is committed to helping men and women with bladder dysfunction. She specifically completed a sabbatical in Glasgow Scotland, Queen Elizabeth hospital where sacral neuromodulation is performed as a tertiary service for Scotland.
She also travelled to Queen Elizabeth II hospital in Birmingham, UK, to add to her experience and knowledge of this procedure.
Dr Kong participates in discussions and meetings nationally that are particularly focused on patients who may benefit from sacral neuromodulation.
Dr Kong can see patients within a few days to a week if they have urgent clinical needs. She is happy to review your referral at any time.