Sacral Neuromodulation (SN)

Urinary incontinence, frequent urination and various problems with urinating can make social life difficult. Due to congenital diseases or diseases that emerge later in life, patients might even fear leaving their homes, which significantly impacts their quality of life. There are multiple treatment methods to eliminate these problems.

First, patients are encouraged to change their habits, and medication treatment is followed. Bladder problems that cannot be solved with these methods are treated with Botox application inside the bladder. When all these interventions fail, the next treatment stage is sacral neuromodulation.

SN triggers the nerves in the bladder with a pacer to treat this problem. The sacral neuromodulation application is a safe and simple application with a high success rate for urination disorders.

What is Bladder Sacral Neuromodulation Surgery?

Sacral neuromodulation treatment, which is applied to patients who experience problems with urinary incontinence, is a high-tech surgical operation that enables stimulating the nerves regulating intestine and bladder functions and regulating the functions of these systems.

The cable used in sacral neuromodulation treatment is placed on the nerves of the bladder and intestine above the femur. The subcutaneous pacer stimulates the nerves and regulates bladder and intestine functions. Sacral neuromodulation surgery will prevent complaints such as urinary incontinence, frequent urination and gas leaks. The sacral neuromodulation system can be programmed, started, and stopped from outside for patients with special treatment needs.

Who can Undergo Sacral Neuromodulation?

SN surgery is suitable for patients with the following complaints:

• Urinary incontinence patients who do not respond to medication and Botox,
• Individuals who urinate frequently (more than 8 times per day),
• Individuals who cannot hold their urine,
• Individuals with an interstitial cystitis complaint with cystoscopy,
• Individuals who feel urinary urgency,
• Individuals with chronic pelvic pain,
• Individuals with chronic gas and stool leaks,
• Individuals with chronic constipation.

Who Cannot have Sacral Neuromodulation?

Some patients are not suitable for SN surgery. The unsuitable patient group for sacral neuromodulation operations is as follows:

• Individuals with poor general health,
• Individuals with infections in the operating region,
• Individuals with insufficient mental capacity,
• Individuals with rectal prolapsus problems,
• Individuals with cardiac disease that requires a ventricular stimulator,
• Pregnant women,
• Individuals with structural bladder abnormality, prostate enlargement and malignity,
• Individuals who do not respond to SN tests.

How is Sacral Neuromodulation Surgery Performed?

SN surgery, which will help patients who experience bladder problems, is a simple surgery. SN surgery is a two-stage operation performed under local or general anaesthesia, depending on the patient’s needs and requirements. A mobile X-ray device is used. SN surgery is performed by using imaging techniques, and the pacer is placed on the nerve in the bladder and intestine from the femur. The pacer is placed with a needle.

• Test application: An electrode is placed 5–6 cm deep in the skin around the rectum. The tip of the electrode is connected to the pacemaker, and the pacemaker is tested for a few weeks. The first stage, the test stage of sacral neuromodulation surgery, involves monitoring whether the patient’s complaints decrease.
• Permanent application: If the patient experiences decreased complaints after a 15-day test application, the permanent pacemaker is placed subcutaneously by hiding the electrode tip. Sacral neuromodulation surgery performed by an experienced team is a surgery with a high success rate that eliminates urinary problems without permanent damage. The pacemaker can be used for 10 years.

Patients can go back to their daily life on the same day or a 1-day hospitalisation after the SN surgery.

How is a SN Used?

The SN is the most important treatment option for patients with urinary incontinence, urinating problems and frequent urination that cannot be solved with medication and other treatments before a surgical operation. The SN, which is the same size as a heart pacemaker, is placed on the sacral nerve. When electric signals stimulate the sacral nerve, the nerves in the bladder are stimulated to eliminate urinary problems. Individuals who have undergone bladder surgery are given a control device to adjust the pacer and to turn it on/off whenever they want. It is possible to eliminate huge surgeries, such as removing the bladder, for patients who experience urinary problems. The success rate can be up to 80% when the patient is suitable for this treatment.

Advantages of SN Surgery

Sacral neuromodulation, which increases the quality of life of patients, has the following advantages:

• When other methods do not work, patients do not need to undergo a huge operation using this method.
• Complaints such as chronic pelvic pain and bladder pain syndrome are decreased.
• The testing stage will prevent unnecessary operations and increase the chance of success.
• The success rate for patients with urinary incontinence and frequent urinary problems is around 80%.
• The pacemaker can be adjusted and turned off with a controller.
• Individuals can go back to their social lives without worrying.

Sacral Neuromodulation Price

The success of the SN depends on the general health status of the individual. The SN yields different results for each patient, and bladder pacer prices are a common question. However, it is not possible to give an exact SN surgery price. Because each patient has a different level of nerve damage, the test stage might not be successful for all patients. Since sacral neuromodulation operation is a technical procedure, the equipment’s quality, doctor’s experience and expertise and the health institution play an important role. The SN’s price is determined by considering all these factors, and the most accurate information about the price can be provided by the health institution where the patients will undergo their operations.