Advanced, Effective, and Safe OAB Therapy
Sacral neuromodulation (SNM) is an effective advanced OAB therapy where a small pacemaker-like battery device is implanted into a patient’s back, stimulating the sacral nerves that help control the bladder and partly control bladder function. The procedure is often performed after it has become clear that conservative therapies like pelvic floor exercises and lifestyle changes have failed to improve the symptoms of an overactive bladder. You may have heard of the Axonics® and InterStim™ devices.
Overactive bladder patients at Georgia Urology are introduced to our proprietary OAB pathway, ensuring exceptional, tailored care. We recognize that each case of overactive bladder is different; thus, there is no one-size-fits-all solution. With a network of nurses, staff, and urologists available to our patients, we track patients through their treatment and journey, adjusting as necessary and optimizing their care for long-term relief.
One of the most compelling benefits of choosing sacral neuromodulation is that patients can trial the device with a simple and short in-office test to see if it will help. During the trial, an external battery is connected to temporary leads (thin wires) that are placed near the appropriate nerve bundles. The trial period typically lasts 4-5 days, during which time patient data is collected to determine whether the trial was successful. After a successful trial phase, the temporary leads are removed, and the patient can be scheduled for surgery. Even if the in-office test fails, we can employ more advanced lead placement tests that often result in a successful final result.
Sacral neuromodulation surgery involves implanting a small battery in the lower back that is connected to a permanent lead, which stimulates the appropriate nerves. The battery can be rechargeable or recharge-free. The entire surgery is performed under sedation at a hospital or an ambulatory surgery center. Most patients are up and about quickly after surgery. Discomfort after surgery is often described as mild and easily controlled with over-the-counter pain medication. A few postoperative considerations include proper wound care and minimal strenuous activity for up to a week or until cleared by the surgeon.
Sacral neuromodulation is reserved for patients who have not experienced significant improvement after conservative therapies. It effectively reduces the symptoms of OAB, so the satisfaction rate of these procedures is exceptionally high. In addition, because it is a permanently implanted device, patients do not to have to come back to the office for repeat treatment.
Sacral neuromodulation has satisfaction rates similar to BOTOX but does not require a follow-up procedure every six months or so. Learn more about BOTOX for OAB
Percutaneous tibial nerve stimulation uses a similar principle to SNM, but rather than directly stimulating the sacral nerves in the lower back, it does so indirectly by stimulating a nerve in the ankle. While PTNS is less invasive, it requires monthly maintenance visits after an initial 12-week therapeutic period. Learn more about PTNS for OAB
As with any surgical procedure, no matter how minor, there are some associated risks, most of which revolve around pain and infection. Each of these can be minimized by employing a highly skilled and experienced surgeon and following post-op instructions closely. In addition to the surgical risk, there is an uncommon risk that the stimulator does not function correctly, which requires replacement and/or removal. Also rare is when the stimulator does not offer as much relief as the trial, though this is often solved with programing the device.
The stimulator can last up to 15 years, depending on the setting. At this point, the battery can be easily replaced in a minor follow-up surgical procedure. Rechargeable batteries require a simple charge every few months.
There is also a small risk of lead damage or migration, requiring a follow-up procedure to reposition them.
Two sacral neuromodulator devices are on the market today, Axonics® from Boston Scientific and InterStim™ from Medtronic. Georgia Urology physicians use both, and several providers have been designated as centers of excellence physicians. While the two devices are essentially interchangeable in form and function, we encourage you to learn more about each device and speak to your urologist about which may be best for you.
To learn more about our overactive bladder treatment program, we encourage you to schedule a consultation with one of our urologists. Remember, while overactive bladder is very common, you do not need to live with its symptoms any longer. Getting relief is just around the corner, and we look forward to being a part of your care.
Are you one of the millions of men and women grappling with the daily challenges of an overactive bladder, urinary frequency, or urinary incontinence? These issues can disrupt your life,...
Read Article
Georgia Urology, the largest practice in Georgia, announced that Dr. Carl Capelouto has been designated as a Center of Excellence for Axonics® — a device that gently stimulates the sacral...
Read Article
