Sacral Nerve Neuromodulation for the Treatment of Bowel Incontinence

If you have not had success with more conservative therapies for chronic bowel control problems or if bowel incontinence has worsened and is significantly diminishing your quality of life, sacral neuromodulation therapy – an advanced treatment for bowel incontinence - may be right for you.

What is Sacral Neuromodulation for Bowel Incontinence?

The sacral nerves help control bowel function. When there is a communication breakdown between these nerves and the brain, bowel incontinence results because the bowels do not function properly.

 

Sacral neuromodulation delivered through the InterStim® system has been FDA-approved to treat bowel incontinence and is a proven treatment option that targets the communication problem between the brain and the sacral nerves.

InterStim

 

InterStim therapy uses a small neurotransmitter device that can be compared to a pacemaker. The small device is surgically implanted into the lower back. The neuromodulation device sends mild electrical impulses to modulate the sacral nerves, helping the nerves regulate bowel function and diminish symptoms of bowel incontinence including leakage of liquid and solid stools. 

 

Is Sacral Neuromodulation Right for You?

To make certain this therapy is right for you, your urologist will start you with a test stimulator that does not require surgery. The test typically lasts five to seven days. The test stimulator involves temporary placement of a thin wire that is worn in your lower back. The wire is connected to a small external stimulator which is worn on a belt around your waist. The stimulator sends mild electrical impulses through the wire to the nerves that involve bowel function.

Your doctor and/or Chesapeake Urology’s incontinence nurse navigator will provide you with detailed instructions on how to operate the test stimulator to ensure the most effective evaluation.  Throughout the testing phase, your provider will ask you to keep a diary to record your bowel symptoms and determine if you have experienced improvement. You and your urologist will review the diary and decide whether permanent InterStim therapy is right for you.

 

Implanting the InterStim Device

InterStim (1)If the evaluation phase has shown improvement in your symptoms and you feel comfortable using the InterStim therapy, your urologist will talk to you about next steps for implanting the device (left). The InterStim neurostimulator device is easily implanted under the skin in your upper buttock (pictured above) during a short surgical procedure performed by your urologist.

You will also have a small incision in your lower back where your doctor will place a long-term electrode. The neurostimulator will send electrical pulses through the electrode to one of your sacral nerves. You will also receive a patient programmer which tells you if the stimulation is on or off and the level of stimulation. Your doctor will set the stimulator to a level that is most effective for controlling your bowel symptoms.

Your doctor will see you back in the office within four weeks following the implantation to ensure the neurostimulator is performing optimally and to discuss any questions or concerns you may have.

 

Benefits of Sacral Neuromodulation

Many patients report significant improvement in their bowel incontinence after having the InterStim device implanted. Benefits include:

  • Significantly improved quality of life.
  • Proven control to stop or greatly reduce accidents.

Studies of patients followed for one year found that seven out of every 10 patients experienced at least a 50% reduction in weekly accidents compared with accidents before starting InterStim therapy. [source]

 

Risks of Sacral Neuromodulation

Side effects associated with sacral neuromodulation are uncommon, but if discomfort or problems do arise, the therapy is reversible by turning off or surgically removing the InterStim device.

The risks are similar to any surgical procedure and may include:

  • Post-operative swelling, bruising, and bleeding.
  • Pain at the implant site.
  • Infection.
  • Lead (thin wire) movement, technical or device problems.
  • Undesirable changes in urinary or bowel function.
  • Uncomfortable stimulation.