Sacral Neuromodulator (SNM)
Reason for inserting a Sacral Neuromodulator
This procedure is performed in patients with proven bladder
- dysfunction from overactive bladder with frequency, urgency and urge incontinence and
- under active bladders with incomplete emptying
What occurs during the operation
A small electrode wire is placed alongside the nerves supplying the bladder at the S3 nerve root. This is then stimulated with a very low current which has the effect of reconfiguring the neural pathways between the brain and the bladder. It is somewhat like a pacemaker for the bladder.
With overactive bladders this is a two step procedure, performed under sedation. The first procedure is the trial implant, where the electrode is inserted and a small lead exits the skin to a controller. If there is a clear improvement of your symptom with the trial, the permanent neuromodulator generator is inserted into the buttock area with a second procedure. With under active bladders the permanent electrode will be implanted into the sacral nerves in the lower back and the permanent generator will be placed in your buttock area in the one procedure.
What to expect post operatively
Your implant will be switched on and programmed before you go home. When the implant is switched on, you will fee a tapping sensation in the genital or rectal area. A very slight buzzing sensation can be sometimes felt in the perineum (between the legs), though this is not always the case. It is not painful, and it usually stops as your body gets used to it. When you have adjusted it, you usually do not feel anything, even though it is still working.
The Medtronic Representative will teach you how to work the controller and go through the individually designed programs until you get the desired improvements.
After going home
Dr Hadley’s expertise is in the insertion of the device, the Medtronic Rep’s expertise is in programming the device, by altering multiple variables, to improve your symptoms. Four programs are pre-set, and you will learn to change them as needed to get the results you desire. Every few months you will see both Dr Hadley and your Medtronic Rep to check on your progress.
Potential Complications
Infections are rare but can be quite devastating if they occur as they usually require complete removal of the device. If the site is painful, hot and red, particularly if there is a discharge, then you need to see Dr Hadley urgently.
The device site can become painful without an infection, particularly if you are quite thin, in which case it may need to be re sited. This is uncomfortable but not urgent. The battery in the generator usually lasts 5-7 years before replacement.
If you experience any post operative complications please contact Dr Hadley’s office on 31637400 and for after hours please follow the prompts.
Post operative appointment
Dr Hadley will catch up with you in his rooms at your post op appointment to discuss his findings. This appointment should have already been made for you at the time of booking your procedure date.
