As the director of a Continence Center, I am dedicated to staying at the forefront of advancements in the treatment of incontinence. Over the past few years, significant progress has been made in addressing both urinary and fecal incontinence—two conditions that significantly impact the quality of life for millions of people worldwide. While there are numerous treatments available, the newest and most effective therapy to emerge in recent years is sacral neuromodulation (SNM). It has rapidly gained recognition as a breakthrough option due to its high success rates and minimal side effects, making it one of the most promising treatments for both urinary and fecal incontinence.
Understanding Incontinence
Incontinence is a broad term that refers to the involuntary loss of bladder or bowel control, leading to urinary or fecal leakage. It can range from occasional leaks to a complete inability to control the bladder or bowel. Urinary incontinence affects millions of people, often due to weak pelvic muscles, nerve damage, or overactive bladder muscles. Similarly, fecal incontinence can result from muscle or nerve damage, commonly occurring in individuals with previous surgeries, childbirth injuries, or gastrointestinal disorders.
Traditional treatments for these conditions include pelvic floor physical therapy, lifestyle changes, medications, and surgical interventions. The published effectiveness of these therapies is not great, and they come with limitations, such as inconsistent results, unwanted side effects, and the need for invasive surgeries. This is where sacral neuromodulation stands out.
What is Sacral Neuromodulation?
Sacral neuromodulation (SNM) is an innovative, minimally invasive therapy that has proven to be remarkably effective in treating both urinary and fecal incontinence. The treatment works by modulating the sacral nerves—specifically, the S3 and S4 nerve roots—that control bladder, bowel, and pelvic floor muscles. These nerves regulate the communication between sacral plexus and the muscles, but also all the way to the brain and the pelvic organs, a system of nerve signaling which can becomes dysfunctional in individuals with incontinence.
SNM involves the implantation of a small device, similar to a pacemaker, under the skin in the lower back or buttocks (think of a flat coin under the skin around the area of your back pocket.) The device sends very mild, computerized electrical impulses to the sacral nerves, helping restore normal communication complex sphincter and pelvic floor muscles. By regulating these signals, SNM significantly reduces, or even completely eliminates, episodes of incontinence.
Why Sacral Neuromodulation is a Game Changer
Sacral neuromodulation is considered the gold standard for treating incontinence for several key reasons:
1. High Success Rates
Sacral neuromodulation has demonstrated impressive success rates for both urinary and fecal incontinence. Studies show that for patients with urinary incontinence, approximately 90% experience significant improvement, with many achieving complete continence. Similarly, for fecal incontinence, studies indicate that SNM results in patients regaining control over their bowel movements, with a marked reduction in leakage episodes.
2. Minimally Invasive 20-minute Procedure
One of the standout features of SNM is its minimally invasive nature. The minor procedure is performed on an outpatient basis, and the recovery time is very short compared to more invasive surgical treatments. Because the implant is small and the minor procedure is less complex, patients can often return to their normal activities within a day or two, making it an appealing option for individuals seeking effective treatment without pain, risks, and extensive downtime.
3. Reversible and Adjustable
Unlike many surgical interventions that are permanent, sacral neuromodulation is completely reversible. If a patient is unsatisfied with the results or experiences any discomfort, the device can be turned off or removed without causing any lasting effects. Additionally, the settings on the device can be adjusted over time to tailor the therapy to the individual’s specific needs, ensuring optimal results.
4. Minimal Side Effects
One of the most significant advantages of SNM is the minimal side effects it carries compared to other treatments. Medications commonly prescribed for incontinence often come with side effects such as memory impairment, dry mouth, constipation, drowsiness, or dizziness. Surgical treatments can be invasive and carry risks of complications like infections, bleeding, painful recovery, mesh erosion (in the case of sling surgeries), and chronic pain. In contrast, the most common side effects of SNM—minor discomfort at the implant site or temporary muscle spasms—are rare and generally resolve quickly. The device itself is designed to be highly discreet, and most patients do not even notice it is there after implantation.
5. Long-Term Efficacy
Another key benefit of sacral neuromodulation is its long-term efficacy. Studies have shown that the benefits of SNM extend well beyond the initial years following implantation. Many patients continue to experience significant symptom relief for years, with the device providing a reliable and sustained solution for incontinence. Today’s devices have battery life of 15 years.
The Procedure: Simple and Effective
The SNM procedure typically involves two stages. The first stage is a test phase called the “trial phase” or “test stimulation.” During this phase, a temporary cat-whisker like lead is inserted in the tailbone area near the sacral plexus, and the patient wears an external stimulator for a few days. This allows the healthcare provider to determine whether the therapy is effective for that individual. If the patient experiences significant improvement, they can proceed to the second stage, where a permanent implant is placed under the skin in a 20-minute minor procedure.
The simplicity of the trial phase is one of the appealing aspects of sacral neuromodulation. Patients get the opportunity to test the therapy before committing to the permanent device, which reduces uncertainty and allows them to make an informed decision about proceeding with the treatment.
Sacral Neuromodulation for Both Urinary and Fecal Incontinence
What makes sacral neuromodulation particularly remarkable is that it effectively treats both urinary and fecal incontinence, simultaneously. For patients who suffer from both conditions—referred to as double incontinence—SNM offers a single, cohesive treatment option that addresses both issues. This dual benefit is a significant advantage for patients who otherwise might require multiple treatments or surgeries to manage their symptoms.
The Bottom Line
Sacral neuromodulation is truly a breakthrough in the treatment of incontinence, offering hope to millions of individuals who struggle with the life-altering symptoms of urinary and fecal leakage. As a minimally invasive, highly effective, and low-risk treatment, it has quickly become the most advanced and successful option for patients who have not found relief through other methods.
In my role as director of The Continence Center at Nevada Surgical here in Reno, I have seen firsthand the transformative impact that sacral neuromodulation has on patients’ lives. It not only restores control over bladder and bowel function but also improves overall quality of life—allowing individuals to regain their confidence, dignity, and independence. For anyone suffering from incontinence, sacral neuromodulation represents the future of treatment, with fewer side effects and long-lasting results.
If you’d like to learn more, contact the team here at Nevada Surgical today. We’d love to answer your questions.
