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Sacral Nerve Stimulation

Overview

Sacral nerve stimulation is where the sacral nerves, which connect the brain and the muscles in the anal region (specifically the pelvic floor muscles, the anal sphincter and the rectum) are 'stimulated using an electrode. The electrode provides a constant low voltage current which helps patients have more sensation of the rectal area and can help patients with severe faecal incontinence.

The treatment is also referred to as 'sacral nerve neuro-modulation'. It is not suitable for all forms of faecal incontinence - less severe forms (for example caused by trauma to the sphincter) are generally treated with an anal sphincter repair.

If an initial test placement of the electrode shows that this will help the patient have greater feeling and sensation in the area, and greater control over bowel function, an electrode can be fitted permanently to the sacral nerves.

How should I prepare for surgery?

The day before admission we will contact you to confirm admission time and to give you instructions regarding any fasting requirements for the procedure. You should bring any x-rays in with you (and ensure you take them with you when you are discharged). Also bring any current medication in with you to the hospital.

For day procedures you should not drive yourself home when you are discharged – please ensure you have made other transport arrangements.

If you smoke, you should reduce smoking before your procedure. Our strong recommendation is that you give up entirely at least 6 weeks before the procedure, or at least one week beforehand. Smoking greatly increases the possibility of chest infection and hampers natural wound healing.

In the case of major surgery, please inform Dr White's team if you take:

  • Warfarin.
  • Aspirin.
  • Plavix.
  • Anti-inflammatory medication.

We will need to discuss these medications with you prior to your surgery.

Dr White will provide you with a full set of pre-operative instructions for your specific surgery well ahead of the day of surgery.

What is involved in the procedure?

Sacral nerve stimulation electrode placement normally takes 60 minutes or less and is generally performed as a day procedure under general anaesthetic. Where an initial trial period is successful, a permanent neurostimulator is then fitted.

Recovery Guidelines

Pain Management

There should be only minimal pain after this procedure and normal pain relief medication (eg paracetamol) should be sufficient.

Wound Care

A waterproof dressing is placed over the wound. This dressing can be removed one week after the procedure.

Recovery Period

Light day-to-day activity should be taken up immediately after the procedure. Within 7-10 days you can resume all normal activities, apart from heavy manual work/lifting heavy objects, which should wait until after the 4-week mark after the procedure.

Surgical Risks

All types of surgery are subject to the following risks, which are rare, but can occur:

  • Allergic reaction to medication / anaesthetic.
  • Bleeding.
  • Difficulty breathing.
  • Infection.

In addition, risks specific to this particular procedure include:

  • Fracture of the electrode lead (~1% risk).
  • High impedance/short circuit in electrode lead (~5% risk).

Both of these situations are easily corrected.

When to contact Dr White

Most surgical procedures are uneventful, with minimal complications. However, you need to be aware of the following symptoms as they may indicate a developing serious complication...

  • Fever.
  • Excess bleeding.
  • Difficulty urinating.
  • Severe or increasing pain.

If you experience any of these symptoms or have any concerns after your surgery, please contact the rooms on 07 5598 0955 for advice.

A post operative appointment will be made for you before you are discharged from hospital. If you are discharged on a weekend, after normal surgery hours or it is not clear what follow up appointments are required, then contact the rooms the next working day to make an appointment.