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October 23, 2015

Sacral nerve stimulation helps school-age and teenage children control urinary incontinence and fecal soiling.

SACRAL NERVE STIMULATION
(SNS) is a new treatment that helps control urinary incontinence and fecal soiling. For some children, the nerves that control urination and bowel movements do not work correctly. The SNS unit consists of a small, safe battery and wire under the skin and sends signals to the sacral nerve. The signals help restore normal function and prevent accidents. SNS can be used on school-age and teenage children after other treatments have failed. If the medical team determines SNS is appropriate treatment, a two-part procedure is required to place the SNS unit under the skin.
The Two-Part Procedure

PART 1: THE TRIAL SIMULATOR

First, the physician/surgeon performs a trial to ensure SNS will work for the patient before placing a permanent stimulator. This procedure is done in an outpatient surgery setting under general anesthesia along with local anesthesia for additional pain control.

A temporary lead is inserted at the sacrum at the S3 posterior foramen. An electrode is connected to an external pulse generator, which generates a signal for 3–5 days. If the patient responds positively during this trial period, the next option is to implant a permanent electrode for permanent sacral neuromodulation.

 

PART 2: PERMANENT IMPLANTATION

Permanent surgical implantation of the SNS unit is performed as an outpatient procedure under general anesthesia. The SNS neurostimulator is implanted under the skin of the patient in the upper buttock area. Thin wires, or leads, running from the stimulator carry electrical pulses from the stimulator to the sacral nerves located in the lower back. These impulses influence the sacral nerves, which provide bladder control by altering the bladder sphincter and pelvic floor muscles. SNS also improves bowel control by reducing fecal incontinence and constipation.