Sacral neuromodulation is one of those technology things that “just works.” You don’t have to think about it, do anything about it, or push any buttons. Once implanted during a 20-minute painless minor procedure, it simply works to resolve bladder and bowel leakage. But what makes you a good candidate for sacral neuromodulation? Here’s the short answer: A good candidate for sacral neuromodulation (SNM) is someone with pelvic floor, bladder, or bowel conditions that are not resolved with conservative or medical management. In other words, if things like exercises or medicines have not worked, SNM is worth a close look. In the longer answer below, we’re sharing characteristics and conditions that make someone a strong candidate for SNM.
Key Characteristics of a Good Candidate for SNM
If you’re navigating incontinence issues that affect your quality of life, you’re likely a good candidate. Here’s what else signals your eligibility:
- Refractory symptoms: Persistent symptoms despite adherence to recommended first-line treatments.
- Desire for minimally invasive options: Patients who want to avoid or are not suitable for more invasive surgical treatments.
- Ability to undergo trial or test procedure: SNM begins with a temporary trial period to test its effectiveness. Candidates must be willing and able to participate in this phase for a few days.
Candidates may not be suitable if they:
- Have an active infection, particularly in the sacral area.
- Are pregnant.
- Have significant anatomical abnormalities preventing proper lead placement.
Medical Conditions Appropriate for SNM
SNM is FDA-approved and paid for by Medicare and other health insurance. It’s commonly used to treat specific medical conditions, including bladder and bowel disorders.
Bladder Disorders
- Overactive Bladder (OAB): Symptoms include urgency, frequency, and urge urinary incontinence that don’t respond to behavioral therapies or medications.
- Non-Obstructive Urinary Retention: This is characterized by a difficulty or inability to fully empty the bladder despite no anatomical blockage.
- Chronic Urinary Incontinence: This describes a loss of bladder control. If you wear pads to manage leakage, for example, you’re dealing with a chronic condition.
Bowel Disorders
- Fecal Incontinence: This is the involuntary loss of stool not resolved with conservative treatments, such as dietary changes, pelvic floor therapy, or medications.
- Chronic Constipation (off-label use in some regions): This describes severe and refractory cases of slow-transit or functional constipation.
Failure of Conservative Treatments
SNM is considered after patients have tried and failed or cannot tolerate some of the following treatments:
- Behavioral Modifications: Bladder or bowel training, timed voiding, and pelvic floor exercises.
- Medications: Anticholinergics, beta-3 agonists, or fiber for OAB and bowel disorders.
- Physical Therapies: Biofeedback or physical therapy targeting pelvic floor dysfunction.
Realistic Expectations and Commitment
It’s important to set realistic expectations and clarify the level of commitment on the patient side. First, while many patients experience tremendous success, patients should understand that SNM improves symptoms but may not completely resolve them for everyone. Second, be aware that SNM devices require regular follow-up appointments for programming adjustments and battery management (especially with older non-rechargeable systems).
The Bottom Line
You are a good candidate for sacral neuromodulation if you have bladder or bowel conditions that impact your quality of life, have tried conservative treatment options, and are willing to undergo a trial of the therapy. In Reno, the team here at Nevada Surgical is happy to answer questions and offer an individualized assessment of your eligibility for SNM. Contact us today to get started.
