What is Sacral Neuromodulation? (Bladder Pacemaker)
Urology

What is Sacral Neuromodulation? (Bladder Pacemaker)

    Sacral neuromodulation, also known as bladder pacemaker, is a method used in the treatment of urinary tract problems such as urinary incontinence, urgency, and urinary retention. This treatment aims to regulate bladder and urinary tract control through nerve stimulation. The procedure involves electrical stimulation of the nerves in the body.

    This treatment method is performed using a stimulation device. The device is implanted in the lower back region where the sacral nerves are located and stimulates the nerves with a mild electric current. This electrical stimulation improves the regular functioning of the bladder and urinary tract muscles, thereby enhancing urinary control.

    What is Sacral Neuromodulation in Neurogenic Bladder?

    In neurogenic bladder, sacral neuromodulation, also known as bladder pacemaker, is a method used to treat urinary incontinence caused by nerve damage known as neurogenic bladder. This condition occurs when the bladder cannot function normally due to damage in the nervous system.

    Sacral neuromodulation in neurogenic bladder is performed using the technique of sacral neuromodulation. The stimulation device stimulates the sacral nerves, enabling the bladder muscles to function in a regular manner. As a result, urinary problems such as incontinence or urgency in neurogenic bladder are reduced or eliminated.

    Who is Suitable for Bladder Pacemaker Application?

    Bladder pacemaker, also known as sacral neuromodulation, can be applied to individuals experiencing various urinary tract problems. Below are the situations where bladder pacemaker application is appropriate:

    1. Neurogenic bladder: Bladder pacemaker can be applied to individuals who experience bladder control issues due to damage in the nervous system.
    2. Urinary incontinence: Bladder pacemaker treatment may be considered for individuals experiencing constant or sudden urinary incontinence.
    3. Urinary urgency: Bladder pacemaker can be used for individuals who frequently and misleadingly feel the need to urinate.

    These situations encompass example scenarios where bladder pacemaker application may be considered for the treatment of urinary tract problems. However, since each individual's condition is unique, consulting a healthcare professional is necessary for a definitive evaluation.

    What are the Advantages of Bladder Pacemaker Application?

    Bladder pacemaker application has several advantages in the treatment of urinary tract problems. Here are some benefits of bladder pacemaker treatment:

    1. Effective treatment: Bladder pacemaker assists in effectively treating urinary tract problems. Symptoms such as urinary incontinence, urinary urgency, and urinary retention are reduced or completely eliminated.
    2. High success rate: Bladder pacemaker treatment yields successful outcomes in most patients. When applied correctly, it improves urinary control and enhances quality of life.
    3. Non-invasive option: Bladder pacemaker treatment does not require surgical intervention. Apart from the device placement, there are no incisions or surgeries involved.
    4. Adjustable therapy: The bladder pacemaker device allows for adjustable stimulation levels. This enables personalized treatment based on an individual's needs and the severity of their symptoms.

    These advantages make bladder pacemaker application a popular treatment option.

    How is Bladder Pacemaker Evaluation Done for Urinary Problems?

    The evaluation of bladder pacemaker treatment in individuals with urinary problems consists of several steps. Here is a general overview of the evaluation process:

    1. Specialist examination: The first step is a medical examination performed by a urologist or urology specialist. The specialist will evaluate your symptoms, review your medical history, and may request necessary tests.
    2. Tests: Various tests may be conducted to determine the suitability of bladder pacemaker treatment. These may include urine tests, uroflowmetry, bladder capacity measurement, and urodynamic tests.
    3. Trial of conservative treatments: In cases where conservative methods (medications, exercises, etc.) for urinary problems have been ineffective, bladder pacemaker treatment may be considered.
    4. Sacral neuromodulation test: If you are deemed suitable for bladder pacemaker treatment, a trial period called sacral neuromodulation test may be conducted. During this process, a temporary device is implanted, and its effectiveness is assessed.
    5. Definitive treatment: If the sacral neuromodulation test is successful, the bladder pacemaker device is implanted as a definitive treatment.

    The evaluation process may vary depending on the individual's condition. Your specialist will take the necessary steps to determine the most suitable treatment option for you.

    How is Bladder Pacemaker Surgery Performed?

    Bladder pacemaker surgery is typically performed under local anesthesia. The procedure may involve the following steps:

    1. Device placement: The first step is the placement of the bladder pacemaker device. The device is positioned near the sacral nerves in the lower back region. This is usually done in the hip area or the sacrum, which is the triangular bone at the base of the spine.
    2. Electrode placement: Electrodes, which will provide electrical stimulation through the device, are placed near the sacral nerves. The electrodes are typically connected to the sacral nerves through thin wires that are threaded under the device.
    3. Device placement check: During the surgery, a check is conducted to ensure that the device is properly placed and the electrodes are positioned correctly. This check is important to ensure effective transmission of stimulation from the device.
    4. Device programming: A programming device is used to adjust the appropriate operating parameters of the device. These parameters can be personalized based on the individual's symptoms and needs.
    5. Wound closure: After the surgery, the area where the device is placed is carefully closed, and time is given for wound healing.

    While bladder pacemaker surgery is a safe procedure, it, like any surgery, carries some risks.

    Who is Not Suitable for Bladder Pacemaker Treatment?

    Bladder pacemaker treatment may not be applicable in certain cases. The following conditions can be contraindications for bladder pacemaker treatment:

    1. Active infection: If you have an active infection in your body, bladder pacemaker surgery should be postponed. The treatment can be considered after the infection has resolved.
    2. Allergy to related devices: If you have a severe allergy to the materials or components used in the bladder pacemaker device, the treatment cannot be performed.
    3. Bleeding disorders: If you have bleeding problems or a blood clotting disorder, the surgery can be risky.
    4. Pregnancy: Bladder pacemaker surgery is generally not recommended during pregnancy. The treatment can be evaluated after pregnancy.

    These are some situations that can be contraindications for bladder pacemaker treatment. However, consulting a healthcare professional is important to assess treatment options and potential risks.

    What is the Success Rate of Sacral Neuromodulation Treatment?

    Sacral neuromodulation treatment has a high success rate in the management of urinary problems. Most patients experience significant improvement or complete resolution of symptoms. The success rate can vary depending on the type and severity of the condition and individual factors. However, studies have shown that sacral neuromodulation treatment significantly reduces symptoms such as urinary incontinence and urgency.

    Is Bladder Pacemaker (Sacral Neuromodulation) Safe?

    Bladder pacemaker treatment is generally considered a safe and effective option. However, like any medical procedure, there are potential risks involved. Potential risks associated with the procedure and the device can include:

    1. Infection: There is a risk of infection after the surgery. Therefore, careful hygiene measures should be taken post-surgery.
    2. Wound healing issues: Wound healing problems may occur in the area where the device is placed. Although rare, this can happen.
    3. Device-related issues: Electronic or mechanical issues may arise in the area where the device is placed. In such cases, the device may need to be repaired or replaced.
    4. Electrode placement issues: If the electrodes are not placed properly, treatment effectiveness may decrease.

    While these potential risks are rare, a proper evaluation and surgery performed by a specialist can help minimize them.

    In conclusion, bladder pacemaker treatment is an effective option for many individuals with urinary problems. However, since every individual's condition is unique, consulting a urology specialist to evaluate treatment options and potential risks is important.

    The content of the page is for informational purposes only, please consult your doctor for diagnosis and treatment.

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    Medical Editorial Board

    Approved by on 14.07.2023

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    About the Author

    Medical Editorial Board

    Medical Editorial Board

    Approved by on 14.07.2023