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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

Sacral Nerve Stimulation (for Incontinence)

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1-2 weeks
Success rate
70-90%
Recurrence
Variable

What it is

What is Sacral Nerve Stimulation?

Sacral Nerve Stimulation (SNS), also known as sacral neuromodulation, is a minimally invasive procedure for the treatment of fecal incontinence that has failed to respond to more conservative therapies. The therapy involves the implantation of a small, pacemaker-like device (a neurostimulator) that delivers mild electrical pulses to the sacral nerves, which control the bowel and sphincter muscles. The electrical stimulation is thought to modulate the nerve pathways, leading to improved sphincter function, enhanced rectal sensation, and better bowel control. The therapy is performed in two stages: a trial phase to assess efficacy, followed by the implantation of a permanent device if the trial is successful.

Am I a candidate?

Who is a Good Candidate for SNS?

SNS is an ideal treatment for patients with moderate to severe fecal incontinence who have failed or are not candidates for conservative therapies like dietary changes, medications, and pelvic floor physical therapy. It is effective for patients with both passive incontinence (leakage without awareness) and urge incontinence (inability to defer defecation). SNS can be successful in patients with structurally intact sphincter muscles as well as those with minor to moderate sphincter defects. It is a good option for patients who wish to avoid more invasive surgical procedures like sphincteroplasty or a colostomy.

Recovery

What is the Recovery Like?

Recovery after SNS implantation is typically quick. After the initial lead placement (Stage 1), there are activity restrictions for about two weeks to prevent lead migration. After the permanent neurostimulator is implanted (Stage 2), recovery is similar, with most patients returning to normal, non-strenuous activities within a few days. The device is programmed in the office to an optimal stimulation level that provides therapeutic benefit without causing discomfort. Patients are given a handheld programmer to adjust the stimulation level and turn the device on and off as needed.

Risks & considerations

What are the Risks?

While SNS is a safe and reversible procedure, it is not without potential risks and complications. These are generally mild to moderate and can include:

  • Pain at the Implant Site: Discomfort at the neurostimulator pocket or lead site is the most common complaint.
  • Infection: There is a small risk of infection at the implant site, which may require removal of the device.
  • Lead Migration or Breakage: The stimulating lead can move from its optimal position, leading to a loss of efficacy and requiring a revision procedure.
  • Unwanted Stimulation or Sensation: Some patients may experience uncomfortable or unpleasant sensations from the stimulation, which can usually be corrected by reprogramming the device.
  • Device Malfunction: The neurostimulator battery will need to be replaced every 3-5 years, requiring a minor surgical procedure.

Sources

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