Sacral Neuromodulation

Sacral Neuromodulation is a therapy to control abnormally functioning bladder and bowels. In addition, it is also used for various forms of pelvic pain. A stimulator is implanted in the patient which sends electrical signals to the sacral nerves. The sacral nerves supply and receive input from the bladder, bowel and pain receptors of the pelvis.

The Sunninghill Unit works in close collaboration with the Pelvic and Urotherapy Institute of South Africa. This is a unique unit on the African continent that assesses and manages various types of pelvic problems. Therefore, the care that patients with urinary incontinence, urinary retention, bowel incontinence and dysfunction as well as pelvic pain receive, is second to none in this state of the art unit.

Image of an Interstim™ II device, supplied by Medtronic
Interstim™ II System – Supplied by Medtronic

Potential patients for neurostimulation are assessed very carefully by a multidisciplinary team to ensure a very high success rate of treatment of 90%. Currently, the unit has a better treatment outcome than the worldwide average which is around 70%.

Types of patients treated include those with chronic pelvic pain including

  • CRPS type pain
  • multiple sclerosis patients
  • patients with spinal injuries
  • patients with severe over active bladder and non-functioning bladders, intractable interstitial cystitis etc.

Frequently Asked Questions

What does this procedure entail?

The procedure is performed in two stages both under general anaesthetic. The first stage entails the placement of a stimulator lead along one of the major sacral nerves. This lead is connected to a temporary stimulator to gauge the efficacy of the treatment.  After two weeks a decision is made on how well the bladder is responding to the stimulation. If there is a good response the second procedure which is relatively short entails placing a small computer into one of the buttocks of the patient which is linked to the stimulator lead.

Anticipated level of pain during and after the procedure?

The procedure is done under general anaesthetic and there is minimal pain experienced once it is done.

Anticipated duration of hospital stay?

Once the surgical procedure is completed, patients are normally discharged after only a few hours.

how soon after the procedure can normal daily activities be resumed?

Within a day but major physical activity is curtailed for a month. Horse riding and other activities involving a lot of jostling are not encouraged to reduce the chances that the lead could be dislodged.

how soon after the procedure can I start driving again?

Usually the next day

how soon after the procedure will i be able to travel?

Within 24-hours.

Will my sexual function and/or fertility be affected by the procedure?

No.

Would this procedure have any affect on my quality of life going forward?

Usually none unless a complication occurs such as an infection or rarely stimulator induced pain. For most patients they have an improvement in the quality of their lives.

What to expect at my follow-up visit.

An assessment of the efficacy of the treatment. Ensuring that healing is occurring. Managing any minor concerns of the patient.

For more information please follow these links:

http://urotherapy.co.za/
Interstim™ II – Medtronic

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