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Sacral Neuromodulation

Bladder and bowel control with SMN

Sacral neuromodulation (SNM) is a procedure used to treat symptoms of overactive bladder (OAB) as well as chronic urinary non-obstructive retention and faecal incontinence for patients who have not responded to medication or physiotherapy.1,2 It is designed to target the miscommunication between the brain and the pelvic floor, whilst most medications target the muscular component of the bladder.

For example, the bladder may be overactive causing urgency or underactive causing retention. By modulating the nerves that control bladder function with mild electrical pulses, SNM addresses this miscommunication.

According to the joint guidelines published by the Urological Society of Australia and New Zealand (USANZ) and Urogynaecological Society of Australasia (UGSA) “SNM should be considered for those patients with refractory OAB who are willing to undertake a minimally invasive surgical procedure and are motivated to work with programming techniques. It may have particular application in those patients who are unable to self-catheterise or in whom there is co-existing faecal incontinence.” (Level of Evidence 1, Grade of Recommendation A).

Risk factors for incontinence6

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