What is Sacral Nerve Stimulator Implantation

Sacral nerve stimulator implantation is a procedure to implant a device under your skin that will generate mild electrical impulses. The device is implanted in the area of your upper buttocks.

Wires are also inserted into your body so that electrical impulses generated by the device can be sent to the sacral nerves. The sacral nerves control several functions in the lower part of the body, including bladder and bowel functions.

Sacral nerve stimulation can be used to treat various disorders that cause problems with urinary or bowel control.

After the device is implanted, it can be used 24 hours a day. The intensity and frequency of the pulses are programmed for each individual and can be adjusted.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Movement of the electrode away from the place where it was inserted (migration).
• Failure of the stimulator.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins. Fluids and medicine will flow into your body through this tube.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Long needles will be inserted into your lower back. Your health care provider will use a type of X-ray (fluoroscopy) to guide the needles to the right spot. The needles will be guided to the left or right of the third hole in the back (S3 foramen) of the bone at the base of your spine (sacrum). This is the place where the nerves exit the backbone.
• The position of the needles will be tested. If they are in the right spot, your toes or feet may move. You may feel a tingling in your legs.
• Electrodes will be inserted through the needles and into your body.
• The electrodes will be anchored in place close to your sacral nerves.
• Small incisions will be made under the skin in your upper buttocks. The sacral nerve stimulator device will be placed in this area.
• The ends of the electrodes that attach to the stimulator will be guided under your skin. They will extend from your sacral nerves, where they are anchored, to the stimulator device. They will then be attached to the device.
• The rate at which the nerve stimulator will deliver electric pulses will be programmed.
• The incisions will be closed with stitches or staples.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Do not drive for 24 hours if you received a sedative.

Sacral Nerve Stimulator Implantation, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have soreness or pain in the incision area.

Follow these instructions at home:

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Follow instructions from your health care provider about any restrictions on activities. You may need to avoid activities that involve a lot of bending, twisting, or bouncing.
• Do not lift anything that is heavier than 10 lb (4.5 kg).

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Keep all follow-up visits as told by your health care provider. This is important.

Use Instructions for the Sacral Nerve Stimulator Device

• You will be given a remote control device. This device will allow you to turn your sacral nerve stimulator on and off. Follow instructions from your health care provider about how to use this device.
• Tell all of your health care providers that you have this device. Remind them that you have the device before they do any tests or procedures.

Contact a health care provider if:

• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.