Bladder pacemaker (Sacral Neuromodulation) surgery differs from many other surgeries as it offers patients the opportunity to test the success of the treatment before a permanent device is implanted. The treatment process is planned according to the patient's condition and carried out transparently. In this article, the stages of bladder pacemaker surgery, namely the temporary trial phase and the permanent pacemaker implantation processes, are detailed.
Stage 1: Temporary Trial Phase (Test Phase)
The first step of the treatment is to determine whether the patient will benefit from this device. In a procedure lasting approximately 20 minutes under local or general anesthesia, a thin temporary electrode is placed near the sacral nerve through the buttock. The end of this lead is connected to an external portable temporary battery generator. The patient is discharged and keeps a diary for 1 to 3 weeks to track:
- The reduction in the number of urinary incontinence episodes,
- Changes in urination frequency,
- The course of interstitial cystitis pain.
If an improvement of at least 50% or more is achieved in the patient's symptoms, the trial is considered successful, and the permanent implant stage is initiated.
Stage 2: Permanent Pacemaker Implantation
For patients with a successful trial phase, a small permanent battery generator is placed into the subcutaneous fatty tissue of the buttock during a short operation performed under local anesthesia or mild sedation. No wires remain outside, and the incision is closed with aesthetic sutures. Pacemaker parameters can be adjusted externally with a wireless remote control.