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Sacral Neuromodulation (Nerve Stimulation)

Sacral Neuromodulation can be of use in the management of overactive bladder and urinary retention and involves implantation of an electrode alongside the third sacral nerve (located at the base of the spine).

Who may benefit?

Voiding dysfunction in the form of either urinary urgency or retention has a severe impact on an individual's quality of life. Urinary urgency as a result of an overactive bladder can be quite difficult to treat. The mainstays of treatment are bladder retraining combined with anti-cholinergic medications such as oxybutynin and occasionally surgery. Sacral neuromodulation is approved for use in Australia for bladder over activity which has failed to respond to 12 months of conservative management thus offering hope for a group of patients who previously had very limited options. The other group of patients who may benefit are those who have urinary retention due to bladder dysfunction, which has failed to respond to 12 months of conservative treatment.

What is sacral Neuromodulation?

Sacral neuromodulation involves placing an electrode alongside the 3rd sacral nerve, which is then connected to a stimulator somewhat similar to a pacemaker. A very low voltage pulse is sent through the electrode, which alters the way, the nerve functions in turn altering bladder function.

What is involved?

Sacral neuromodulation is generally performed in 2 stages. The initial or test phase involves placing an electrode through a needle so that it sits next to the 3rd sacral nerve. This is done under x-ray guidance and general anaesthetic. Following this the electrode is connected to a small external device for up to 2 weeks. If during the test period there is a significant improvement in symptoms the permanent stimulator is then placed under the skin of the back. Both procedures are completely reversible.