Most of us are familiar with the concept of a pacemaker for a faulty heart rhythm. But how does the same technology work in the treatment of incontinence? How, specifically, does sacral neuromodulation stop bowel and bladder leakage?
Understanding the Role of the Pacemaker
If we think of the heart as a complex muscle and nerve system, we know that sometimes that system goes awry. That’s when the normal signaling throughout the nerves and muscles required to have the perfect heartbeat simply stops working properly. The heart begins beating in the wrong kind of rhythm, which can cause all kinds of problems. The solution for millions of people has been an amazing technology that involves implanting a small miniature computer. This device sends a signal to the heart in just such a location, and in just such a way, that it restores that normal heartbeat. It’s a pretty amazing technology, and these days, it’s also extremely common. My dad had one placed, and the procedure took about 20 minutes.
So, with that idea in mind, one can imagine the muscles and nerves that are involved in allowing us to properly empty the bladder and rectum. It’s very similar in the sense that the complex muscle and nerve system, known as the pelvic floor, has to work in just the right sequence with some muscles contracting and others relaxing, all in the proper order. If any of that those steps go awry, then the proper sequence is disrupted, and a person may have leakage from the bladder, or the rectum, embarrassing accidents, a more frequent need to void, or failure to completely empty the rectum or bladder (know as “urinary retention”).
You can imagine what has happened next to solve this problem. Doctors and pacemaking engineers collaborated to understand the precise nature of that nerve and musce signaling and action in the pelvic floor to create a new type of pacemaker. This one would work quite similarly to the heart pacemaker , but instead of being implanted on the chest wall up near the heart, it would be implanted down by the pelvic floor, usually slipped under the skin by your back pocket. It’s a place where even the skinniest of us has enough padding that the thin little device is not usually even appreciated or at all visible.
Sacral Neuromodulation for Incontinence
Now the interesting part starts. The lead wire to transmit this fancy computerized signal to restore the normal bowel and bladder emptying works in complex ways. It not only transmits a direct stimulus to the nerve plexus, telling the various muscles at the end of the line to contract, but it also plays an important role with what are called “inhibitory” signals, the ones that turn muscles off. Even more fascinating, researchers have found that some of the signaling gets transmitted all the way up and down the spinal cord to brain nuclei and back. The truth is that no one is quite sure which of all of those computerized signals and body responses are precisely responsible for the net effect of restoring the bowel and bladder control and eliminating the embarrassing accidents, leakage, overactive bladder, and urinary retention.
Suffice it to say that the computer signal is very effective. It solves bladder and bowel problems with a remarkably simple and noninvasive 20-minute procedure nowadays—like my dad’s pacemaker—that places an unobtrusive implant without much fuss, and with a 15-year battery life. Ninety percent of people report success resolving the accidents, leakage, overactive, bladder, bowel accidents, urinary retention, and incomplete bladder emptying. With the progress of neuromodulation technologies, such as this one, we even expect that number will continue to increase.
For more information about incontinence treatments, contact the Nevada Surgical team today.