InSight: Restoring Normal Habits

InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD
(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.
This story appeared in the Fall/Winter 2015 print issue. Download the print issue. 

About the author

Tiasha is the senior strategist for Clinical & Research Communications at Nationwide Children's Hospital. She provides assistance to investigators in The Research Institute and clinician-scientists at Nationwide Children’s for internal and external communication of clinical studies, peer-reviewed journal articles, grant awards and research news. She is also the editor-in-chief for Research Now, Nationwide Children's monthly, all-employee e-newsletter for research, as well as a writer for Pediatrics Nationwide.