What is Sacral Nerve Stimulation?

Sacral Nerve Stimulation, also known as sacroneuromodulation, sacral neuromodulation, Axonics procedure, or Interstim procedure is a procedure used to treat symptoms of Overactive Bladder (frequency, urgency, nocturia and urge urinary incontinence), urinary retention and fecal incontinence , who have tried and failed conservative and medical management.

How does Sacral Nerve Stimulation work?

Sacral Nerve Stimulation alters the sacral nerves that go to and come from the bladder. By stimulating these nerves, the brain and bladder can better communicate with each other. The device is composed of two parts, the lead wire, and the generator/stimulator. The lead wire is placed near the sacral nerves. This wire is then connected to a generator/stimulator which is implanted under the skin near the buttocks. A handheld device is used to adjust the level of stimulation.

What conditions does Sacral Nerve Stimulation treat?

Sacral Neuromodulation can treat the following conditions: Overactive Bladder Urinary Urgency Urinary Frequency Nocturia Urge Urinary Incontinence Fecal Incontinence or accidental bowel leakage Urinary Retention

How is Sacral Nerve Stimulation implantation performed?

Dr. Stone perform will first perform an evaluation phase where he will determine whether or sacral nerve stimulation works for you. The 2nd phase is the implantation phase where implant is placed under the skin. Dr. Stone can perform the evaluation phase in 2 different ways, being either a basic or an advanced evaluation. Basic Evaluation Dr. Stone performs the first portion of this procedure in the office. It involves the placement of a small temporary wire near the sacral nerve which is then connected to an external generator/stimulator. The wire will stay in place for 2-3 days and then is removed. Based on your response, Dr. Stone will either plan on a full implantation or discuss alternatives with you. The full implantation involves a 45 minute procedure in the operating room. You will be put to sleep and a permanent wire implantation near the sacral nerve which is then connected to a generator which is implanted under the skin. The advantages of this approach is the first portion can be performed in the office. The disadvantage of this approach is that the evaluation phase is short and may not give enough information to make an informed decision on whether to perform the permanent implantation. Advanced Evaluation Dr. Stone performs both portions of this procedure in the operating room. The evaluation phase involves placement of a wire near the sacral nerve, which is then connected to a external generator/stimulator. This wire can stay in place indefinitely, which allows you and Dr. Stone a longer period of time for evaluation, usually 1-3 weeks. If you experience significant improvement of your symptoms he will then perform the 2nd phase, which is a permanent implant, also in the operating room

What are the risks of this procedure?

The risks include the following: Pain near incision and implant site Lead migration Wound infection

What is Interstim and Axonics and which one is better?

There are two companies that currently market these devices. Dr. Stone is trained to implant either one. He will discuss with you the advantages and disadvantages of the two products and together you can come to a decision. Interstim Interstim II Advantages Has been on the market the longest and has the most data behind it No need to recharge the battery The battery lasts 5-10 years Disadvantages Cannot have an MRI below the head Larger in size compared to Axonics and Interstim Micro Needs to be replaced every 5-10 years Interstim Micro Advantages Newer Technology Rechargeable Smaller in size MRI compatible Disadvantaged Needs to be wirelessly recharged every 2 weeks Not as well studied compared to Interstim II Axonics Advantages Newer technology Rechargeable Smaller in Size compared to Interstim II MRI compatible Last 18 years Disadvantages Needs to be wirelessly recharged every 2 weeks using a special belt Not as well studied compared to Interstim II

What are the alternatives to Sacral Nerve Stimulation?

There are a couple of alternatives to sacral Neuromodulation. Bladder Botox - This is an office procedure where a portion of the bladder is injected with botox. Percutaneous Tibial Nerve Stimulation - This is a series of treatments done in the office where the nerve by your ankle will be stimulated with a very small needle.

What are further resources I can read about Sacral Nerve Stimulation?

Gormley EA, Lightner DJ, Faraday M, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 2015; 193:1572. Interstim II System. Medtronic, Inc; 2020. https://www.medtronic.com/us-en/healthcare-professionals/products/urology/sacral-neuromodulation-systems/interstim-ii.html Axonics Sacral Neuromodulation System. US FDA approved product information. Irvine, CA: Axonics; 2019 https://www.accessdata.fda.gov/cdrh_docs/pdf18/P180046D.pdf

Sacral Nerve Stimulation Specialist

Home » Treatments » Sacral Nerve Stimulation

Dr. Daniel Stone, MD FACOG

Urogynecologist located in Phoenix, AZ

Dr. Daniel Stone, MD performs Sacral Nerve Stimulation implantation (Axonics and Interstim) for patients in the Phoenix, Scottsdale and surrounding Arizona areas. These procedures can help patients that suffer from Urge Urinary Incontinence, Overactive Bladder, Fecal Incontinence, Urinary Retention, or Neurogenic Bladder.

Sacral Nerve Stimulation Q & A

What is Sacral Nerve Stimulation?
Sacral Nerve Stimulation, also known as sacroneuromodulation, sacral neuromodulation, Axonics procedure, or Interstim procedure is a procedure used to treat symptoms of Overactive Bladder (frequency, urgency, nocturia and urge urinary incontinence), urinary retention and fecal incontinence, who have tried and failed conservative and medical management.
How does Sacral Nerve Stimulation work?
Sacral Nerve Stimulation alters the sacral nerves that go to and come from the bladder. By stimulating these nerves, the brain and bladder can better communicate with each other.
The device is composed of two parts, the lead wire, and the generator/stimulator. The lead wire is placed near the sacral nerves. This wire is then connected to a generator/stimulator which is implanted under the skin near the buttocks. A handheld device is used to adjust the level of stimulation.
What conditions does Sacral Nerve Stimulation treat?
Sacral Neuromodulation can treat the following conditions:
- Overactive Bladder
  - Urinary Urgency
  - Urinary Frequency
  - Nocturia
  - Urge Urinary Incontinence
- Fecal Incontinence or accidental bowel leakage
- Urinary Retention
How is Sacral Nerve Stimulation implantation performed?
Dr. Stone perform will first perform an evaluation phase where he will determine whether or sacral nerve stimulation works for you. The 2nd phase is the implantation phase where implant is placed under the skin. Dr. Stone can perform the evaluation phase in 2 different ways, being either a basic or an advanced evaluation.
Basic Evaluation
Dr. Stone performs the first portion of this procedure in the office. It involves the placement of a small temporary wire near the sacral nerve which is then connected to an external generator/stimulator. The wire will stay in place for 2-3 days and then is removed. Based on your response, Dr. Stone will either plan on a full implantation or discuss alternatives with you. The full implantation involves a 45 minute procedure in the operating room. You will be put to sleep and a permanent wire implantation near the sacral nerve which is then connected to a generator which is implanted under the skin. The advantages of this approach is the first portion can be performed in the office. The disadvantage of this approach is that the evaluation phase is short and may not give enough information to make an informed decision on whether to perform the permanent implantation.
Advanced Evaluation
Dr. Stone performs both portions of this procedure in the operating room. The evaluation phase involves placement of a wire near the sacral nerve, which is then connected to a external generator/stimulator. This wire can stay in place indefinitely, which allows you and Dr. Stone a longer period of time for evaluation, usually 1-3 weeks. If you experience significant improvement of your symptoms he will then perform the 2nd phase, which is a permanent implant, also in the operating room
What are the risks of this procedure?
The risks include the following:
- Pain near incision and implant site
- Lead migration
- Wound infection
What is Interstim and Axonics and which one is better?
There are two companies that currently market these devices. Dr. Stone is trained to implant either one. He will discuss with you the advantages and disadvantages of the two products and together you can come to a decision.
- Interstim
  - Interstim II
    - Advantages
      - Has been on the market the longest and has the most data behind it
      - No need to recharge the battery
      - The battery lasts 5-10 years
    - Disadvantages
      - Cannot have an MRI below the head
      - Larger in size compared to Axonics and Interstim Micro
      - Needs to be replaced every 5-10 years
  - Interstim Micro
    - Advantages
      - Newer Technology
      - Rechargeable
      - Smaller in size
      - MRI compatible
    - Disadvantaged
      - Needs to be wirelessly recharged every 2 weeks
      - Not as well studied compared to Interstim II
- Axonics
  - Advantages
    - Newer technology
    - Rechargeable
    - Smaller in Size compared to Interstim II
    - MRI compatible
    - Last 18 years
  - Disadvantages
    - Needs to be wirelessly recharged every 2 weeks using a special belt
    - Not as well studied compared to Interstim II
What are the alternatives to Sacral Nerve Stimulation?
There are a couple of alternatives to sacral Neuromodulation.
- Bladder Botox - This is an office procedure where a portion of the bladder is injected with botox.
- Percutaneous Tibial Nerve Stimulation - This is a series of treatments done in the office where the nerve by your ankle will be stimulated with a very small needle.
What are further resources I can read about Sacral Nerve Stimulation?

Testimonials

"He actually took the time and listened to me. After the exam he told me that he wanted to try another pessary before committing to surgery. He fit one in and it worked! I haven't felt this good in years. I'm so so grateful to him!"

"He is one of the most caring docs I've ever been to. I've been struggling with this problem for years and have been to 3 docs before I saw him."

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"I highly recommend him. I will be referring all my loved ones if ever they develop problems."

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"Awesome!! Would give him 10 stars!!!!! Dr. Stone took the time to fully explain medical procedures. He patiently answered all my questions."

"His bed-side manner put me at ease discussing a very embarrassing topic. I'd recommend him to anyone."

Major Insurance Providers Accepted

We accept most insurance policies for your convenience. Please contact your insurance carrier to verify your individual benefits and any copays or coinsurance that are part of your plan. Patients are responsible for notifying our office if a specific plan requires precertification, preauthorization, or a referral (especially HMOs). Please call the phone number on the back of your insurance card to verify your provider network participation as insurance carriers change policies often.

Schedule your appointment with Dr. Stone today

One of our staff members will contact you directly. If you have any concerns requiring immediate attention, please don’t hesitate to call us at 602-788-1521.

Dr. Stone is also offering Telemedicine visits. Call to schedule today.

Office location

Valley Urogynecology Associates

1616 East Maryland Avenue

Phoenix, Arizona 85016-1302

Office Hours: Monday-Friday from 8 AM – 5 PM

Main: (602) 788-1521

Fax: (602) 688-5420

Conveniently located just off Highway 51 on Maryland Avenue just East of 16TH Street between East Bethany Home Road and East Glendale Avenue.

Dr. Daniel Stone, MD