Pelvic floor disorders encompass a wide range of conditions that can significantly impact an individual’s quality of life. Urinary retention, or the inability to fully empty the bladder, is one of them. Unfortunately, traditional methods of treatment don’t resolve the issue or its symptoms. But sacral neuromodulation, or SNM, is showing tremendous success. Here’s what makes SNM a revolutionary approach to the treatment of pelvic floor disorders.
What is Urinary Retention?
Urinary retention is a condition in which the bladder fails to empty completely. That creates symptoms including discomfort, recurrent urinary tract infections, and reduced bladder capacity. Certain pelvic floor disorders, such as dysfunctional voiding, neurogenic bladder, or sphincter dyssynergia, can all contribute to urinary retention. These disorders often result from dysfunction or damage to the nerves controlling bladder function. That’s why traditional treatment options for urinary retention, including medications or intermittent catheterization, rarely prove effective. Worse, they’re often associated with significant patient burdens.
How SNM Resolves Pelvic Floor Disorders
Unlike many treatments aimed at managing symptoms, like pads and adult diapers, sacral neuromodulation actually treats the root of the issue. This method of treatment involves the use of a surgically implanted device that — much like a small pacemaker — delivers electrical stimulation to the sacral nerves located near the tailbone or base of the spine. These nerves play a crucial role in controlling bladder function, and modulation of their activity can help restore normal voiding patterns.
The device consists of a neurostimulator and an electrode lead that is placed near the sacral plexus. The neurostimulator sends mild electrical impulses to the sacral nerves, which improves coordination between the bladder and the pelvic floor muscles to an impressive degree. Numerous studies have demonstrated the effectiveness of sacral neuromodulation in treating urinary retention associated with various pelvic floor disorders. Clinical trials have shown significant improvements in multiple parameters, including increased bladder capacity, decreased residual urine volume, and enhanced detrusor muscle activity. Even better, SNM has been found to alleviate symptoms such as urinary urgency, frequency, and incontinence. The sustained efficacy of SNM over long-term follow-up periods — new devices have a battery life of 15 years or more — further establishes its role as a reliable treatment option for urinary retention.
What to Expect During Your Visit
It’s normal to have questions about the SNM appointment. Typically, implantation of the sacral neuromodulation device is performed in two stages. During the first visit, a temporary electrode is placed during a painless 20-minute minor procedure to assess the patient’s response to neuromodulation. If the patient experiences significant improvement in urinary symptoms, a permanent implantation is the performed. This is also a similarly short, painless, minor outpatient procedure that involves the placement of a fully internalized neurostimulator. Post-operative follow-up includes programming adjustments, patient education, and ongoing monitoring of symptom improvement, device functionality, and patient satisfaction. Generally, a person with the implant can simply “set it and forget it” while it works in the background to restore normal bladder function.
Sacral neuromodulation is generally well-tolerated, with a low incidence of serious adverse events. Potential risks are a minor possibility, as they are with any surgical procedure and include infection, device-related complications, and lead migration. Patient counseling regarding these risks and appropriate preoperative optimization are key to minimizing potential complications. Regular follow-up visits and maintenance of the device’s functionality through battery checks and programming adjustments are also essential for ensuring the long-term safety and efficacy of sacral neuromodulation.
The Takeaway
Sacral neuromodulation represents a groundbreaking therapeutic approach for urinary retention in pelvic floor disorders. By providing effective neuromodulation to the sacral nerves, this procedure can restore normal voiding patterns, alleviate symptoms, and improve overall quality of life for individuals suffering from urinary retention. As our understanding of pelvic floor disorders continues to evolve, sacral neuromodulation stands as a transformative intervention, empowering patients and advancing the field of pelvic floor therapy.
To learn more about the efficacy of sacral neuromodulation and whether you may be a candidate, contact the Nevada Surgical team today. We’re happy to answer your questions!
