What is sacral nerve modulation?

Sacral nerve modulation is a treatment for anal incontinence, a condition where you have difficulty controlling bowel movements. This can be caused by damage to the muscles and/or nerves around the anus, often due to childbirth, but it can also affect men and women of all ages.

If there is a significant gap in the anal sphincter muscle, anal sphincter repair is often recommended first. However, if the sphincter is intact or other treatments such as medication and physiotherapy have not worked, sacral nerve modulation may be an option.

Before the procedure, you will need specialist tests to check if you are suitable for implantation. These may include:

• Anorectal physiology tests – To assess nerve and muscle function

• Endoanal ultrasound – To check the anal sphincter structure

• Video proctogram – A specialist X-ray to see how the rectum functions

• Transit studies – To evaluate bowel movement speed and effectiveness

What does the operation involve?

Sacral nerve modulation works by sending electrical impulses to the nerves in the lower back, altering how the rectum and anal sphincter muscles function. The procedure is done in two phases:

Phase 1 – Test phase

• A temporary wire is inserted into the lower back under short general anaesthetic

• The procedure takes around 30 minutes

• The wire is connected to an external stimulator worn outside the body

• You will keep a diary for 2-3 weeks to track symptom improvement

• If symptoms improve significantly, the temporary wire is removed, and you move on to the second phase

• Around 70% of patients go on to have a permanent implant

Phase 2 – Permanent implant

• A different wire with multiple electrodes and tiny fins is inserted to prevent movement

• This wire is connected to the implanted stimulator, placed under the skin of the buttock

• The procedure is carried out under general anaesthetic and takes around 40 minutes

What are the risks?

All procedures carry some risks, though sacral nerve modulation is generally very safe.

• Bleeding – Very rare with this type of surgery

• Infection – Uncommon but possible, and usually treated with antibiotics

• Discomfort or movement of the wire – Adjustments can be made if needed

Your consultant will discuss these risks in detail before your procedure.

What happens after the operation?

Both the test phase and permanent implant procedures are day cases, meaning you can go home the same day.

• Minimal pain – Most patients only need simple oral painkillers

• Wound care – After the test wire is placed, dressings must not be disturbed, so you cannot bathe or shower until the wire is removed

• Wire removal – The temporary test wire is removed in the outpatient clinic

• Device programming – After the permanent implant is placed, you will have a follow-up appointment after 2 weeks to fine-tune the settings

Further visits may be required to adjust the device settings for optimal symptom control.

Why choose the Midlands Bowel Clinic?

• Consultant-led care from specialists in bowel dysfunction

• Comprehensive diagnostic testing to determine the best treatment plan for you

• Minimally invasive procedures for faster recovery and long-term symptom relief

• Rapid access to treatment with no long waiting lists

Contact us

If you would like to find out more about sacral nerve modulation and whether this treatment is suitable for you, please get in touch. Our team is here to provide expert guidance and care.