Sacral Neuromodulation

Napa Valley Urology Associates is pleased to offer Sacral Neuromodulation for patients suffering from OAB and non-obstructive urinary retention. If you have tried other therapies and medications and they have been unsuccessful, our Urologist can answer any questions you may have regarding Sacral Neuromodulation. You may also talk to a patient advocate who has undergone such a procedure to learn more.


photo-interstim-iiSacral Neuromodulation (SNM) is indicated for patients who have failed or could not tolerate more conservative treatments for one or more of the following conditions:

  • Overactive bladder (OAB)
    • Urge incontinence
    • Urgency-frequency
  • Non-obstructive urinary retention (UR)
    • Urinary Retention Symptoms: Patients with urinary retention generally experience difficulty initiating a void or completely emptying their bladder. They may take a long time to urinate, producing only a weak trickle which could then cause the need for self-catheterization. They may lose small amounts of urine throughout the day or be unable to sense when the bladder is full.


Sphoto-lower-backacral neuromodulation for voiding dysfunction is delivered via the InterStim® system.

Sacral neuromodulation is evaluated prior to implant. During the evaluation, a lead (thin wire) is placed near the sacral nerves (under skin in your lower back) and connected to an external neurostimulator which you would wear on a belt.  The neurostimulator sends mild electrical pulses through the thin wire to your sacral nerves that influence the behavior of the pelvic floor, lower urinary tract and urinary sphincters. Those pulses may get your bladder and/or your bowel working the way it’s supposed to.

The evaluation allows you to try the therapy and assess not only its efficacy but also its tolerability and sensation so physicians and patients can make an educated decision whether or not to proceed with an InterStim® System implant.


Candidates for SNM Treatment

A broad range of patients with overactive bladder and urinary retention are considered suitable for sacral neuromodulation once they have failed or could not tolerate more conservative treatments.  SNM was FDA-approved in 1997 for urge incontinence, and in 1999 for urgency-frequency and urinary retention.   It consists of a minimally invasive evaluation and implant procedure.

photo-interstim-implantSacral neuromodulation is most appropriate for patients who:

  • Suffer from quality of life issues
  • Experience urge incontinence or urgency-frequency
  • Experience urinary retention without an obstruction
  • Are younger (under 65), active, and motivated to improve their quality of life
  • Desire an alternative to medication

Sacral neuromodulation is not appropriate for patients who:

  • Have not demonstrated an appropriate response to the evaluation
  • Experience primarily stress incontinence
  • May require an MRI
  • Are unable to operate the neuromodulation device
  • Are not appropriate candidates for surgery
  • Have neurogenic OAB or urinary retention
  • Experience urinary retention due to mechanical obstructions such as benign prostatic hypertrophy, cancer, or urethral stricture

Safety and effectiveness of sacral neuromodulation have not been established for patients who:

  • Are pregnant
  • Under age 16
  • Have neurological disease origins such as multiple sclerosis or diabetes
  • Require bilateral stimulation


Side Effects

Patients who have had InterStim Therapy for overactive bladder have reported improvements in the number of incontinence episodes each week, reduction in the number of times they have to visit the toilet, and improved quality of life.  People who have had InterStim Therapy for urinary retention have also reported improved quality of life.  As with any interventional therapy or surgery, you may experience some side effects.   Some side effects with sacral neuromodulation may include pain where the device is implanted, Infection or skin irritation, technical problems, numbness at the neurostimulator site, etc.