Sacral neuromodulation is effective treatment for bladder symptoms that don't respond to medical therapy. If you decide with your doctor that sacral neuromodulation is right for you, then this video will help you understand some of the steps involved in the process. For your first stage procedure, this will take place in the hospital, in an operating room, even though it's only a short procedure. It usually takes about an hour for the whole procedure in total. You'll be on your stomach in the operating room and you'll either get some general anesthesia or potentially also just some local anesthesia to help you be more comfortable with a little bit of sedation, depending on the surgeon's preference. During the actual procedure, there'll be a small skin incision only and the lead or the wire for the device will be placed underneath the skin into the appropriate position. Afterwards, that wire will come out through the skin and be covered by several bandages and then connected externally to a battery, which will be placed in a small fabric belt or like a fanny pack that you'll wear for that week between your two surgeries. Between the two surgeries, you will have bandages covering the surgical area from the first procedure. We ask that you do not touch those bandages, even if you see that there's a little bit of blood on the gauze underneath. If you have any concerns, you can always call your surgeon for questions, but we want to keep this area clean and dry and covered so that we ask that instead of showering or taking a bath, you do only sponge baths between these two procedures, keeping that area safe and dry. What are the risks of this procedure? The risk of the stage one procedure are very low. The most common risk is infection of the device requiring removal of the lead in its entirety. This fortunately is very rare. Sometimes the lead can potentially migrate and occasionally there will be a malfunction of the device. All of these require removal of the device, but again, it happened very infrequently. If you are at least 50% improved, then we will proceed to stage two. If you do not experience improvement, even with adjustment of the device, then the second procedure will be removal of the lead. This is also done under local anesthesia with a little bit of sedation or possibly general anesthesia. On the day of your stage two procedure, you will be at the hospital for a shorter period of time. The prior small incision above your buttock will be enlarged slightly in order to accommodate the permanent battery. You will also be given a new programmer with a display that is exactly the same as the one that you were given during stage one. Your Medtronic representative will discuss the stimulator and programmer with you after your procedure in detail. Please be reassured that your doctor and the representative are available for you to help you with this process. Ideally, you will feel some stimulation in the area between the vagina and the rectum, also called the perineum. In the ideal scenario, also, you will have complete resolution or close to complete resolution of your symptoms. Over the subsequent days and weeks, you will make fine adjustments with your programmer based on your symptomatology. You will also be given an identification band to carry with you. This will be important when you're traveling, such as when you go through security at the airport. So this is your remote that you're going to have, okay? This is simply used to turn the stimulation up or down. The only reason why we want you to turn it up is if your symptoms aren't doing well and if they're improving and you're seeing a nice improvement with your urinary symptoms, then just leave it alone. There's nothing to touch, okay? So the first thing you do to turn it on is you want to press the button on the side. Then you can just swipe anywhere on the screen, okay? And then after that, all you do is press the up arrow to go up and then down arrow to go down, okay? So you'll turn the stimulation up until you feel it. So what are you going to feel? You're going to feel like a little vibration or fluttering sensation down in your vaginal area. For men, it will be in their scrotal area, and we want you to put it to where it's comfortable. A minimal level is fine, okay? If it's too strong and it hurts, then let's just turn it down to a comfortable level, okay? And once you're done, you just press the same button on the side, and that's it, okay? You do not have to carry this remote around with you. You can leave it at home. You can go about your day. But if we want you to turn it up, obviously it has to be close to you and you need to turn it up from there. So with your programmer comes a charger. So just like any phone, I'm sure you have a smartphone, it's a disabled cell phone, you can use your charger to go ahead and charge it, and it just plugs in on the side, on the bottom here, okay? And then you can also see the percentage just on the top there of how much percentage or how much charge you have. When can I exercise again? We typically allow full activity after approximately two weeks once the skin incision has closed. When can I go in the jacuzzi or the ocean? We usually allow a full two weeks after the stage two procedure so that your skin can heal and you can resume water activities. Do I need to carry the programmer with me at all times? No, you do not. You only need to use the programmer if you want to adjust the device. Many patients don't need to adjust the device at all. Adjustment of the settings is only needed if you don't experience adequate improvement.

Sacral neuromodulation

bladder symptoms

medical therapy

hospital procedure

permanent battery