Sacral nerve stimulation, also known as sacral neuromodulation is an option for the management of patients with faecal incontinence.
Conservative treatment of faecal incontinence includes lifestyle changes, pelvic floor muscle training and medications.
Sacral nerve stimulation is considered in individuals who have found no relief through conservative therapy.
Sacral nerve stimulation uses mild electrical impulses to stimulate the sacral nerves, at the base of the spine, that control the bowel and pelvic muscles. Stimulation of these nerves may alleviate your symptoms of faecal incontinence and help restore normal bowel function.
In this procedure, a small device known as a neurotransmitter is implanted under the skin of the upper buttock region and a mild electrical current is transmitted through lead wires to stimulate the sacral nerves. This helps regulate the functioning of the bowel and related muscles.
Sacral neuromodulation involves two stages:
Stage 1: This is a test phase where a stimulation lead is implanted in a subcutaneous pocket in the upper outer quadrant of the buttock, for 1 to 2 weeks, to evaluate the patient’s response to the stimulation and check if stimulation improves faecal incontinence symptoms. This procedure normally takes 30 to 45 minutes.
Stage II: This phase is done after successful completion of the test phase. Permanent surgical implantation of the neurotransmitter device is performed in this phase.
This procedure normally takes about 30 minutes and is performed under general anaesthesia. Your surgeon will make a small incision on the skin over the upper buttock region. Then, a small device called a neurotransmitter is implanted under the skin of the upper buttock region. Another small incision is made over the lower back for implanting a long –term electrode. The neurotransmitter device sends mild electrical impulses through a lead, to the sacral nerves which influence the functioning of the sphincters, and the pelvic floor muscles.
What to expect post-operatively
Following the procedure, the area around the incision may feel tender for a few days… You may need to make several visits to your doctor’s office to adjust or fine tune the settings of the neurotransmitter device. Once the settings have been adjusted to your requirements, you may require less frequent check-ups; once or twice a year.
Limit your activities during the first 3 to 6 weeks, of the procedure, to allow the incision to heal. After the incision has fully healed, patients are encouraged to resume an active lifestyle.
The neurostimulator battery life may vary depending on individual settings and frequency of use per day. The entire neurostimulator needs to be replaced every 3 to 5 years.
Patients with an implanted neurostimulator device need to avoid MRI scans, x-rays and radiation therapy as these may affect the functioning of the device. Always consult your doctor to discuss precautions necessary before undergoing any additional tests.
Sacral nerve stimulation helps alleviate the symptoms of faecal incontinence. It is a reversible treatment that can be removed at any time without any injury to the nerves.
The risks associated with sacral neuromodulation therapy are minimal. However, risks may be caused by problems related to the device or the implantation procedure, requiring a reprogramming of the device. The risks associated with sacral neuromodulation include: