Sacral Neuromodulation (SNM).

Sacral Neuromodulation (SNM), otherwise known as Sacral Nerve Stimulation (SNS) is an NHS-funded treatment option for people with bladder and bowel problems. From this subset of the population, numerous individuals had career ending injuries whose lives may have been changed with an effective treatment. However, this should be understood that SNM is not an issue for all areas of the biosphere. Doctors as well as other health care providers including specialists who are qualified to assess whether the therapy is a good fit for you or those in your charge.

The effective management of SNM, however, has led to this practice being much more widely accepted as a means by which normal bladder or bowel function can be restored. All together, more than 200,000 people around the world have received this therapy so far which demonstrates both its global output and effectiveness. In one way or another, SNM can reduce symptoms that start to make significant discomfort thanks direct communication Bladder & Bowel with the Brain. Usually, they will try out a therapy for a few weeks — this is what we refer to as the diagnostic trial of that particular treatment.

Whilst it may be a key element of so many children's’ lives, the practise of bowel management is undeveloped in terms healthcare delivery for these individuals throughout the UK. At the Bladder & Bowel Community we are here to make sure everyone knows how much information and support they need. So that they be evaluated accurately and then receive therapies adapted to their individual needs.

WHAT DOES SACRAL NEUROMODULATION TREAT?

The versatility of Sacral Neuromodulation as a therapy results in its utility for divergent conditions. In fact, one of its most common uses is for the treatment of faecal incontinence which results from an inability to control bowel movements. SNM is also one of the treatment options for overactive bladder syndrome (also known as OAB-wet or urinary urge incontinence), which involves a sudden, extreme need to urinate. This therapy is especially helpful if other more conservative treatments — like lifestyle changes, dietary shifts or medication and biofeedback have not given relieve earlier.

Is Sacral Neuromodulation Right for Me?

Consideration for Sacral Neuromodulation Following evaluation, further treatments including less invasive options will be considered before deciding to undergo sacral neuromodulation. Conservative therapies may include dietary changes, lifestyle modifications such as regular exercise or relaxation techniques, medications (many classes of which have been shown to potentially contribute to anal incontinence due pharmacologic side effects), and biofeedback. If these efforts are not sufficient enough to satisfy the patient or if they become difficult for patients to adhere too than often a specialist referral will be made. A physician will perform extensive evaluations to determine if SNM is a viable treatment.

Sacral Neuromodulation procedurally entails two main steps, namely Evaluation Phase and Implant Stage. This stage is particularly important since it enables both the patient and healthcare provider to evaluate whether or not such therapy could lead to notable symptom reduction. Patients are usually asked to keep a diary of their toilet habits and symptoms for several weeks before the assessment commences. This diary acts as a control for reference in the evaluation period.

Evaluation Step: Determining If SNM Is A Fit

The evaluation phase of Sacral Neuromodulation includes the temporary placement of a slender wire close to sacral nerves in your lower back, at roughly where the tail base is located. It is these sacral nerves that partially control the functions of our bladder and bowels. A thin lead wire is routed through the vein to a small, electrically stimulating device placed in another area of your body. It will be powered by a battery throughout the evaluation period, and is discreetly worn on the waistband of your pants. The operation itself is usually quick, often less than an hour and can be done as a day case.

When the patient is sent home with a temporary wire in place, they are asked to go back to their daily life and record their toilet habits as usual but this time on a new diary. Over the next 2 weeks, patients must vigilantly report any shift in symptoms. The results are reviewed by the patient's doctor at a follow-up after this period of home evaluation. Success of the evaluation is determined by several factors which are comprised of reduction in frequency and amount of moments before an after test, quality-of-life assessment as well as global patient satisfaction.

Implant phase: chronic sacral neuromodulation

Should this evaluation phase show good results, the patient might be offered a long-term alternative in an implant device called Neurostimulator. It is most commonly inserted just under the skin and close to the high buttock area, usually about one small coin size in length. Throughout the assessment phase, a temporary thin lead was used when replaced with the Neurostimulator allows an implant in to your lower back. This device has an inbuilt battery that usually lasts for up to five years, making it a long-term management option of bladder and bowel symptoms.

If the evaluation had shown no significant improvement after using a temporary wire, this is usually removed and other treatments perhaps considered or another cycle of anesthetic chemotherapy performed in different conditions.

How Sacral Neuromodulation Works

Sacral Neuromodulation works by changing the electric signals that go from your brain to the bladder and bowel muscles. The nerves carry these electrical impulses to the muscles of our body; this is how movement happens. The nerves also follow called major pathways, and those travel to different regions of the body via smaller branches.

The brain sends messages through a very large set of nerve pathways that travel along the spinal cord, and also eventually exits to go down into the legs in an area right at your low back called sacral user. At this point in the process, nerve pathways begin to cleft and branch out towards other regions of pelvis. These nerves control the pelvic floor muscles, urethral sphincters, bladder and anal sphincter muscles. These nerve pathways also relay the sensation of fullness from organs such as the bladder or rectum to your brain.

In some scenarios, the signals directly to these muscles which are from the brain may get cut off and hence no message could be communicated. Sacral Neuromodulation reverses these faulty signals and the bladder/bowel can function correctly.

Want to learn more or get help?

Sacral Neuromodulation is not a cure for everyone and you should discuss your suitability with an experienced healthcare provider. Your GP or a continence clinic specialist can then refer you to the appropriate consultant who will determine if these therapies are suitable for your condition.

If urinary or bowel control problems are affecting your daily life, it is important to see a doctor. Continence nurses and specialist physiotherapists are professionals trained to help manage bladder and bowel problems. With the support, advice and assistance offered by though a clinical psychologist who you can actually help to practice these techniques in order to determine which of them are most suited for your particular circumstances.

Conclusion

When all else has failed, Sacral Neuromodulation provides hope for men and women suffering from intractable bladder and bowel conditions. Patients will be able to assess whether this therapy could provide the relief they are looking for via a thorough evaluation process. Although not a one-size-fits-all solution, SNM has transformed the lives of countless individuals by restoring function and improving quality-of-life. If you are interested in this procedure, please speak with your healthcare provider to determine whether Sacral Neuromodulation is an appropriate choice for you.