- Reference Number: HEY-047/2022
- Departments: GI Physiology
- Last Updated: 1 October 2022
Introduction
This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.
What is Temporary Sacral Nerve Neuromodulation?
Neuromodulation is the use of low voltage electricity to make nerves work better.
You have probably been troubled with difficulty going to the toilet, faecal incontinence or pelvic floor disorders. Following discussion with your doctor they have suggested sacral nerve neuromodulation may be a realistic treatment option for you. This temporary procedure usually lasts two weeks and allows the medical team to assess whether you would be suitable to go on for permanent sacral nerve neuromodulation.
The procedure involves implanting an electrode in your lower back (sacrum) using local anaesthetic and sedation. This electrode neuromodulates the sacral nerve, which is involved in the function of the muscles around your anal canal, bladder and the pelvic floor. This electrode is connected via a wire to an external test device which is worn on a strap around your lower chest.
During your test you will need to keep a diary to record any benefits of the temporary nerve neuromodulation so it can be assessed if a permanent one is suitable for you.
Why do I need Temporary Sacral Nerve Neuromodulation?
Temporary sacral nerve neuromodulation is offered to people who have faecal incontinence and pelvic floor disorders. This is often when other medical or surgical procedures have not worked. By neuromodulating the sacral nerve, the function of the anus and pelvic floor may be improved and therefore improving your symptoms.
This temporary phase is reversible, minimally invasive and will allow the medical team to see if this procedure is suitable for you.
Can there be any complications or risks?
Like all surgery there are potential risks. Some of these risks relate to surgery and anaesthetics, whilst some risks are specific to this procedure.
The risks specific to this procedure relate to the chance of nerve injury or bleeding within the pelvis due to placement of the wires. This complication occurs in less than 1% of patients but may result in further surgery being required.
The area of skin around the temporary wire may get superficially (on the surface) infected. This happens in around 1% of people and usually settles with some antibiotic tablets.
While this is now a well-established low risk operation, there may be other risks and side effects that we are not yet aware of.
How do I prepare for Temporary Sacral Nerve Neuromodulation?
Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.
As with all surgery, you will be asked to stop eating and drinking prior to the procedure. You will be informed when to do this either on your admission letter or at the time of your pre-assessment appointment.
What will happen?
You will be told either at your pre-assessment appointment or admission letter where you should report to and when. You will be seen by a member of the anaesthetic team and by a member of the surgical team who will explain the procedure to you once more and your consent will be taken.
Just before the procedure you will be taken to the operating theatre where you will be for approximately 30 minutes. During this time your surgeon will place the stimulating electrode into your sacrum using a needle which is then removed leaving the electrode in position. This electrode is held in place by a large dressing which should stay in place until the electrode is removed two weeks later.
You will then need to recover from the sedation. You will feel some mild discomfort from the area where the electrode has been placed.
You will see a healthcare professional who will connect the electrode to the test device, show you how to control it and then you will be able to go home. Please note that you are not allowed to drive after the procedure so please make arrangements to get home.
What will happen afterwards?
Once you are discharged from hospital it is advised to carry on with normal life as much as possible.
Avoid baths and full showers as the dressing and electrode should not get wet. If the dressing starts to peel off, simply cover over the existing one with another. The original dressing should not be removed.
You will be given a diary to record possible benefits of the test. This is important as the medical team will be able to assess if the procedure will be beneficial to you and whether or not to go onto the permanent stage. Accurate record keeping is also necessary as it forms part of the funding application should it progress to a permanent implant.
You will be asked to return to hospital two weeks following the procedure to have the electrode removed; this will take approximately five minutes.
The results of the procedure will be reviewed at your two week follow up appointment and you will be consulted as to whether a permanent sacral nerve neuromodulation procedure is appropriate.
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Department of GI Physiology (01482) 624036
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
