Can Incontinence Be Reversed?

Posted on: 24th Nov, 2023


Men and women struggling with symptoms of incontinence in silence, and often in shame, aren’t alone. Urinary incontinence, or bladder leakage, is extremely common, and most people do not realize it can be reversed with treatment. Fecal incontinence, or bowel leakage, is also a lot more common than most people realize, and treatments usually reverse this condition as well.  So what is the cornerstone therapy at the best centers in the world? After interventions like dietary and fluid intake modification, pelvic floor exercises, and a trial of medications, the surprisingly simple and effective therapy is a type of pacemaker that uses advanced technology that restores the body’s natural nerves and muscles. It’s called sacral neuromodulation (SNM), and it really can help reverse incontinence.

SNM has emerged as a groundbreaking therapeutic modality in the field of incontinence, and it’s effective for the management of both fecal and urinary incontinence. Incontinence, characterized by the involuntary leakage of urine or stool, can significantly impact an individual’s quality of life. Traditional treatment approaches, such as medications and behavioral therapies, may provide symptom relief but often fall short of achieving a complete reversal of the condition. In recent years, doctors have unlocked the potential of SNM as a transformative intervention capable of not only managing but also reversing incontinence.

Understanding Sacral Neuromodulation

SNM involves the targeted modulation of the sacral nerves, specifically the S3 and S4 nerve roots, to influence bowel, bladder and pelvic floor function. This is achieved through the implantation of a small device, often referred to as a “pelvic floor pacemaker” or “interstim device,” which delivers controlled electrical impulses to the sacral nerves. These impulses modulate the neural pathways involved in bladder control, resulting in improved function and reduced symptoms.

The exact mechanism by which sacral neuromodulation exerts its therapeutic effects is not fully understood, but several hypotheses have been proposed. One prevailing theory suggests that SNM modifies the communication between the local nerves and the pelvic floor muscles, as well as between the brain and the bowel/bladder sphincters, leading to enhanced control over voiding function. Additionally, SNM may influence the reflex arcs involved in bowel and bladder contraction and relaxation, contributing to improved continence.

While complete reversal of incontinence may not be achievable for all patients, sacral neuromodulation has demonstrated remarkable success in significantly reducing or eliminating symptoms in a substantial majority of individuals. Clinical studies and real-world experience have shown that SNM can lead to improvements in bowel control, bladder storage and voiding function, as well as a decrease in the frequency and severity of incontinence episodes.

The impact of sacral neuromodulation on incontinence reversal can be attributed to several factors:

  • Restoration of nerve function. SNM targets dysfunctional neural pathways, restoring communication between the brain and the bladder. This can result in improved coordination and control over bowel and bladder function.
  • Modulation of reflex arcs. The electrical impulses delivered by the sacral neuromodulation device may influence the reflex arcs involved in bladder contraction and relaxation. This modulation contributes to the restoration of normal bowel and bladder function and control.
  • Patient-specific adjustments. One of the key advantages of sacral neuromodulation is its adaptability. The device settings can be customized to meet the unique needs of each patient, allowing for personalized adjustments that optimize therapeutic outcomes.
  • Clinical evidence. Numerous clinical studies have investigated the efficacy of sacral neuromodulation in treating various types of incontinence, including fecal incontinence, overactive bladder, urgency urinary incontinence, stress urinary incontinence, and mixed urinary incontinence. The results consistently demonstrate significant improvements in continence parameters, with many patients experiencing a substantial reduction in incontinence episodes.

The Bottom Line

Sacral neuromodulation represents a revolutionary approach in the management of urinary incontinence, offering a potential avenue for the reversal of symptoms. While SNM may not completely reverse incontinence for every patient, the substantial improvements seen in most individuals underscore its transformative impact on bowel and bladder function. As research in this field continues to evolve, sacral neuromodulation stands as a beacon of hope for those seeking a more comprehensive solution to their incontinence concerns.

If you’re interested in learning more about SNM and whether you might be a candidate, contact the Nevada Surgical team today.

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