Global Sacral Nerve Stimulation: An Effective Treatment for Urinary and Fecal Incontinence

 

Global Sacral Nerve Stimulation

What is it?

Sacral nerve stimulation (SNS) is a minimally invasive surgical procedure that uses mild electrical pulses to stimulate the sacral nerves located in the lower back. These nerves control bladder and bowel function. By modulating nerve activity, SNS can help restore normal bladder and bowel control in patients suffering from urinary and/or fecal incontinence.

How does it Work?

During the Global Sacral Nerve Stimulation procedure, a small wire electrode is placed near the sacral nerves through a small incision in the lower back. The electrode is then attached to a neurostimulator device, similar to a pacemaker, which is implanted in the lower abdomen or buttock area. The neurostimulator sends mild electrical pulses to the sacral nerves via the electrode. These pulses help restore coordination between the bladder, bowel and pelvic floor muscles to improve continence. Patients can use a wireless remote to turn the stimulator on or off as needed.

Testing the Response

An initial trial phase is conducted to determine if SNS will provide therapeutic benefits. During this phase, the electrode is temporarily attached to an external pulse generator worn outside the body. If continence significantly improves during the trial period, the patient is considered a responder and eligible for the permanent implant. For those who respond well, a second small surgery is performed to implant the neurostimulator device and attach it to the electrode permanently.

Treating Urinary Incontinence

SNS has proven highly effective in treating urinary incontinence associated with a dysfunctional bladder or pelvic floor. It can help patients regain control over bladder emptying and storage through neuromodulation of the sacral nerves. By coordinating bladder contractions and urethral sphincter muscle relaxation, SNS restores the normal cycle of urination on demand rather than accidental leakage. Studies show over 80% of urinary incontinence patients experience significant improvements in dryness and quality of life after SNS treatment.

Treating Fecal Incontinence

In addition to urinary issues, Sacral nerve stimulation has emerged as a promising therapy for fecal incontinence and associated disorders like constipation. It works by enhancing rectal sensitivity, coordinating evacuation and strengthening anal sphincter muscles through targeted nerve stimulation. Research confirms SNS provides relief from fecal accidents and improves bowel control in over 60% of fecal incontinence patients. For some, it can even restore full continence. SNS offers an effective alternative to colostomy for those who fail more conservative therapies.

Long-Term Benefits and Maintenance

If the trial phase proves effective, the permanent SNS implant typically provides lasting relief from incontinence symptoms over many years. Patients simply use the remote control as needed to activate stimulation sessions, which typically last 30 minutes at a time. Routine follow-ups with their doctor allow evaluation of symptoms and stimulator battery life. Batteries generally last 3-5 years before replacement surgery is required. With proper maintenance, SNS successfully manages incontinence long-term for the majority of patients.

Expanding Global Acceptance

Once only available at leading specialty centers, SNS is now an established treatment offered by urologists and colorectal surgeons worldwide. Its effectiveness and ability to improve quality of life have led to expanding reimbursement and approvals across Europe, Asia and other global regions in recent decades. Key organizations like the American Urological Association now recognize Sacral nerve stimulation as first-line therapy for refractory urinary and fecal incontinence. As awareness grows, more patients now have access to this life-changing option closer to home.

Improving Outcomes through Innovation

Constant innovation continues to enhance SNS technology and outcomes. Newer devices deliver more sophisticated neuromodulation programs. Some feature rechargeable batteries extending implant lifespan. Smartphone remote controls provide improved remote access. Select SNS systems now incorporate sophisticated sensors and software allowing "stimulation on demand" based on real-time detection of incontinence symptoms. Such advancements promise even higher success rates and improved quality of life for more patients with urinary and fecal incontinence worldwide refractory to conservative treatments.

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