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Sacral Nerve Stimulation
What you need to know about sacral nerve stimulation:
Sacral nerve stimulation (SNS) is treatment for urinary retention without blockage, overactive bladder symptoms, and fecal incontinence. Overactive bladder symptoms include urinary urge incontinence and urinary frequency. Electrical impulses are sent directly to the sacral nerves to improve or restore bladder or bowel function. Sacral nerves are in your lower back. They control anus, rectum, and bladder functioning. SNS is done when medicine and behavior therapy do not help improve symptoms. Implantation of an SNS includes 2 stages. The first stage is a trial phase to see if SNS will improve your symptoms. The second stage involves implanting the stimulator.
How to prepare for sacral nerve stimulation:
Your healthcare provider will talk to you about how to prepare for each stage of this procedure. He or she may tell you not to eat or drink anything after midnight on the day of your procedure. He or she will tell you what medicines to take or not take on the day of your surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection.
What will happen during the first stage of SNS:
You may be given general anesthesia to keep you asleep and free from pain during the procedure. You may instead be given local anesthesia to numb the procedure area. With local anesthesia, you may still feel pressure or pushing during the procedure, but you should not feel any pain. You will be placed on your stomach. A small incision will be made in your upper buttock. A temporary or permanent lead is placed into your lower back, through to your sacral nerves. Your incision will be closed with surgical glue or tape. The lead is connected to an external stimulator. Electrical impulses will be sent to the lead to stimulate your sacral nerves. The lead may be left in place for up to 4 weeks.
What will happen after the first stage of SNS:
You will be asked to keep a record of your symptoms and bladder or bowel function. You will be able to return to your usual daily activities after the procedure. You may be asked to avoid high-impact physical activities during the time that you have an external stimulator in place.
What will happen during the second stage of SNS:
You may be given general anesthesia to keep you asleep and free from pain during the procedure. You may instead be given local anesthesia to numb the procedure area. With local anesthesia, you may still feel pressure or pushing during the procedure, but you should not feel any pain. You will be placed on your stomach. Your healthcare provider will reopen the incision that was made during the first stage. A space is made just under your skin. The stimulator is connected to a permanent lead. Then, the stimulator is placed into the space and the space is closed with stitches. You will be given a programming device to adjust and turn the stimulator off and on as needed.
Risks of SNS:
You may have pain, discomfort and infection in the area where the stimulator was implanted. You may have an allergic reaction to the materials that the lead or stimulator is made from. You may have pain or feel a shock during stimulation. The lead may move and you may need to have the procedure done again. You cannot have an MRI of your abdomen or pelvis if you have a stimulator implanted. An MRI can cause the leads to heat up and cause problems with your stimulator. You may set off metal detectors at airports or theft detectors in stores.
Contact your healthcare provider if:
- You have pain at the stimulator site.
- You have a fever.
- Your incision is red, swollen, or has pus coming from it.
- Your symptoms return or get worse.
- You have new pain or new symptoms with stimulation.
- You feel like you are being shocked with the stimulator on or off.
- You have questions or concerns about your condition or care.
You may need any of the following:
- Antibiotics help to prevent a bacterial infection
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Write down your symptoms. Ask your healthcare provider how to complete the diary of symptoms.
- Limit activity such as stretching and lifting. Ask your healthcare provider which activities you should limit and for how long.
- Ask your healthcare provider how to care for the incision at your stimulator site.
- Keep the programming device with you at all times.
- Tell your healthcare providers that you have an implanted sacral nerve stimulation device.
- Keep the card that identifies you have an implanted stimulator, with you at all times.
Follow up with your healthcare provider as directed:
You will need regular visits to monitor your symptoms. Your healthcare provider will also need to check the programming of your device. Bring your diary with symptoms. Write down your questions so you remember to ask them at your visit.
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