Sacral nerve stimulation therapy is a treatment for the symptoms of overactive bladder.
It is a reversible treatment that uses a small device to send electrical impulses to nerves located in the lower back (above the tailbone).
这些神经, 称为骶神经(S2), S3, and S4) alter muscles and organs that contribute to bladder control.
The stimulation can often end or reduce certain bladder and bowel-control problems in some people.
哪些患者通常会接受这种治疗?
We use this therapy to treat an overactive bladder with or without urine leakage and bladder-emptying problems. We may recommend this therapy if conservative treatments, such as drug therapy, have not helped you. 在我们推荐这种疗法之前, you may need to go through a trial of medications and behavioral, 物理治疗.
It is also used for some patients who cannot empty their bladder and some patients with accidental bowel leakage.
这个过程
骶神经刺激手术分两步进行. This allows your physician to test the therapy before actually implanting the permanent battery.
步骤1:测试刺激
Step 1 determines if the treatment will improve your symptoms.
在步骤1之前, keep a bladder or bowel record for at least 3 days to establish a baseline record of your symptoms. 我们将这些数据用于测试刺激后的比较.
In this first step, we implant a permanent lead (a thin wire). Before the procedure, you will need to provide your medical history and have a physical examination. You may also need routine laboratory tests and an EKG (cardiogram).
You will not be able to eat or drink anything after midnight on the day before the surgery. We perform this procedure in the operating room using light sedation.
- 脸朝下躺在检查台上, you receive a local anesthetic into your skin to numb the area. The physician uses an X-ray machine to locate the place to insert the lead.
- 这个过程 involves the insertion of a needle and a lead near the sacral foramen. The sacral nerve is in the lower back, on the left or right side.
- We apply stimulation and we ask you to identify the location of the sensation. The location might be the vagina, rectum, or the space between the vagina and rectum (perineal body). Usually, the sensation is a vibration or pulling sensation in the vagina or rectum.
- Once you feel the sensation, we check the anus (opening to the rectum) or toes. Tightening of the anus or flexing of the big toe occurs when the sacral nerve is being stimulated.
- Once we confirm the response, we thread a lead wire through the needle. Then, we remove the needle leaving the temporary lead wire in place. We tunnel the lead to either the left or right buttock where we create a small pocket. We expand the pocket when we insert the battery following a successful test stimulation.
- We tunnel a lead extension to the opposite buttock from the pocket and bring it up through the skin. This lead extension connects to an external stimulation device. 我们在恢复室给这个装置编程.
试验刺激后
让外部刺激器一天24小时开着. 测试期为1 - 3周.
We may adjust the settings on the external stimulator during this time based on your response to the stimulation.
While you have the test stimulator in place, you should limit some of your activities. For example, no lifting, no sexual intercourse, and no baths.
You will need to record your symptoms using the same bladder or bowel records you used before the Step 1 procedure.
如果你的症状改善了至少50%, long-term use of sacral nerve stimulation therapy may be appropriate for you and you may proceed to Step 2.
Step 2: The implant of the sacral nerve stimulation neurostimulator
You are a good candidate to have implantation of the permanent battery when:
- 你的症状至少减轻50%
- 测试结果让你满意
During the second step, we open the small pocket to make it larger. We place the battery into the pocket and connect it to the permanent lead arising from the sacral nerves.
这个过程 is quick can often be performed under local anesthesia with sedation.
植入手术后
在神经刺激器植入之后, the doctor uses a "programmer" device to set stimulation settings and check information.
我们给你一个手持设备，教你如何使用它. 该设备包括一个可更换电池. The device enables you to control your symptoms by increasing or decreasing the intensity.
You may need to make several visits to fine-tune the settings that are best for you. Typically, the neurostimulator battery lasts for 3 to 5 years. 这可能会根据您的使用需求而有所不同.
刺激器电池
When the battery runs out, you can have it replaced with an outpatient visit surgery. There is a new rechargeable battery which lasts more than 15 years. 如果您选择此选项, you will need to charge the battery with a charger applied over your back, 系着皮带, 每两周约20分钟.