Axonics™ Sacral Neuromodulation

Bladder control problems including overactive bladder (OAB), urinary blockage, fecal incontinence, are treatable and manageable conditions that are not a normal part of aging or a fact of life.

Sacral neuromodulation, or neurostimulation with the Axonics™ device, is a technologically advanced, minimally invasive, reversible, and simple procedure that is performed to treat overactive bladder, urinary urgency, incontinence, urinary blockage, frequency, and bowel (fecal) incontinence in both women and men.

During this procedure, a small, removable, implantable device is placed to test and stimulate the nerves of your bladder to either “quiet” it down or to “help it squeeze better.” Think of it as a “pacemaker” or “white noise machine” for your bladder!

Axonics™ Sacral Neuromodulation Information

Candidates for Neuromodulation:

You are considered a candidate for this procedure if you experience overactive bladder or are unable to urinate due to non-obstructive issues.

You may also be a suitable candidate for the procedure if:
• Medications no longer work, do not work, or cannot be tolerated
• You desire to stop taking medications for your bladder
• You desire for an alternative to bladder injections
• You experience leakage of fecal matter

This procedure is NOT appropriate for you if:
• You experience urinary leakage with coughing, laughing, sneezing, lifting.
• You cannot operate the Axonics neuromodulation device
• You are not considered healthy enough for surgery.
• You experience urinary blockage from your prostate, cancer, or urethral scar tissue.

About the Axonics ™ treatment system

The Axonics ™ device is a tiny implantable device that is made up of two parts: a small wire (lead) and the neurostimulator (“Pacemaker”)

Benefits/Advantages

• The Axonics ™ system is the ONLY MRI safe and compatible neuromodulation device- It does not need to be removed or turned off prior to a MRI
• The battery system is rechargeable and small – meaning greater durability and less discomfort
• Greater than 90% satisfaction rates
• Less than 2% complication rates
• The device is typically installed only once without need for repeat procedures

Results

Patients who undergo the neurostimulation procedure have reported
• Up to 85% satisfaction rates and improvements in quality of life
• Up to 90% of patients have a greater than 50% reduction in symptoms at 6 months
• Up to 45% complete cure and continence rate at 5 years
• Sustained symptom control up to 5 years
• Decreased catheterization volumes and number of catheterizations (for patients with urine blockage)

Procedure Basics / What to expect

There are two parts to the procedure:

Part 1: Testing (Weeks 1-2)
• During this test, a small wire is placed into the nerve location that is responsible for your bladder
• The small wire is connected to a temporary device that will test the nerve. This temporary device will be secured to the outside of your body during this period of time.
• After the testing procedure, you will be instructed to pay attention to your symptoms and note any improvements while at home.
• A Bladder Diary will be provided for you to help keep track of your symptoms
• If you do not note any improvements during this time OR if you dislike the device, it is simply removed.

Part 2: Implanting the Neurostimulation device (Week 2)
• If you experience at least a 50% improvement in your symptoms then a second small day procedure will be scheduled to place the small, discrete, neurostimulator device.
• After this procedure, everything will be “internal”
• You will follow-up with Dr. Tsai as well as the Axonics representative postoperatively to assess your programming.

After the procedure(s):

You will be provided with information on how to operate and use your new device.

• Take your medications as prescribed
• Do not drive while taking narcotic pain medications.
• No lifting restrictions greater than 10 pounds and no strenuous exercise while temporary device is in place. If the permanent device has been implanted, no heavy lifting or strenuous exercise for 2 weeks.
• No tubs or swimming until incisions have completely healed. You may shower. Wash incision sites with soap and water and pat dry with a clean cloth. Do not scrub. May resume regular diet.
• Your incisions will be closed with stitches. These will dissolve on their own and do not need to be removed.
T• he tegaderm (clear dressing) will come off on its own. Once removed, your incisions do not need to be rebandaged.
• Please be sure to keep your follow-up appointment for assessment or programming. If you do not have an appointment please call the clinic for one.