Axonics

If you’re experiencing bowel and bladder issues, and not sure why, your nerves might be to blame. Severely pinched nerves in certain parts of the spine can cause loss of bowel and bladder control, and this is where sacral neuromodulation can help. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas are experts at helping their patients regain their bowel and bladder control with a goal to help them achieve their ideal quality of life. 

What is Sacral Neuromodulation?

When the bladder and bowel function normally, nerves in the spinal cord send messages from the brain to the bladder, telling certain muscles when to tense up and when to relax. This allows people to release urine and stool when intended. Bladder and bowel problems often originate with nerve or muscle dysfunction, as these systems control the flow of urine and the release of stool, resulting in urinary or fecal incontinence. Conditions that may cause this include herniated discs, spinal cord injuries, and cauda equina syndrome (when the cauda equina nerves become compressed). Sacral neuromodulation is technology that acts directly upon the sacral nerves with a goal to normalize – or modulate – nervous tissue function. 

Neuromodulation devices and treatments can be life changing. They affect every area of the body and treat nearly every disease or symptom from headaches to tremors to spinal cord damage to urinary incontinence. While most thought of in the context of chronic pain relief, neuromodulation can also be used for nerve stimulation. 

Sacral neuromodulation works by either actively stimulating nerves by applying electrodes to the brain, the spinal cord or peripheral nerves to produce a natural biological response, or by applying targeted pharmaceutical agents in tiny doses directly to the area of concern.

How Does Axonics® Therapy Work?

One of the main neuromodulation methods available that provide patients with relief is Axonics® Therapy. Axonics® Therapy is sacral neuromodulation for treating symptoms of overactive bladder, bowel incontinence and urinary retention. These issues could be caused by abnormal communication between the brain and bladder or bowel. 

Axonics® Therapy works by using a miniature implant that provides gentle stimulation to the nerves that control the bladder and bowel. When there is normal communication in the body, nerves are sent to the brain that alert that the bladder and bowel are filling or full. The brain then sends signals down that allow the bladder and bowel to empty. If there is abnormal communication, the brain either doesn’t know that the bladder and bowel are filling/full, or doesn’t communicate to empty the bladder and bowel, or to keep the body from emptying them when the person isn’t ready. Axonics® Therapy helps to restore normal communication, which allows for an improvement in symptoms. 

What Does Axonics® Therapy Involve?

Axonics® Therapy works to better regulate the sacral nerves’ function with a goal to restore normal bladder and bowel function. While not all patients are candidates for this treatment option, those who have not responded to more conservative treatments such as changes to diet, medication and physical therapy might benefit. 

After a consultation and diagnosis with your pain management specialist, the procedure itself is performed in three steps. 

1. Trial period and evaluation: Patients will start with a two-week trial period where they wear an external version of the device to determine if the treatment will be effective. The provider places a lead connected to a small, externally-worn device during a 15-minute, minimally invasive outpatient procedure. The external device is worn underneath the patient’s clothing. During this period, the patient resumes their normal activities and determines what it would be like to live with Axonics therapy, how it feels when activated, and if their symptoms are reduced or eliminated.
2. Surgery: If the trial yields positive results, the device is then implanted in the patient’s lower back near the sacral nerves in the back of the pelvis. It is an outpatient surgery, generally offered under local or general anesthesia, that takes around 30 minutes to perform. 
3. Post surgery: Patients can expect to return to normal activity levels within a few weeks. During this time, the provider will specifically configure the device’s stimulation signals based on the feedback from the trial period. Most patients notice a slight feeling of pulling or tingling, with most reporting no longer noticing the electrical impulses after a few weeks. 

Who is a Candidate for Axonics® Therapy?

The first step in determining if Axonics® Therapy could work for you is to have an open and honest discussion with your pain management specialist about the extent of your bladder and/or bowel issues. Overall, though, this therapy method has proven successful for patients who suffer from: 

• Overactive bladder (OAB): a frequent and sudden urge to urinate that may be difficult to control
• Urinary frequency: the need to urinate more often than normal, which may or may not be linked to an underlying disease
• Urinary urgency incontinence (UUI): a common cause of incontinence in elderly people, this is characterized by urgency, followed by involuntary loss of urine
• Fecal (bowel) incontinence: the inability to control bowel movements
• Nonobstructive urinary retention (UR): the inability to completely or partially empty the bladder, including the inability to start or completely finish

Axonics® Therapy has proven to not only provide patients with bladder and bowel control, but also with an improved quality of life where they don’t have to constantly worry about “when” or “if” they might experience a bathroom emergency. Most patients reported satisfaction with the treatment method, which included a reduction in their symptoms and minimal discomfort with the device overall. 

If you have yet to find relief from your bladder and bowel issues after exhausting conservative approaches, sacral neuromodulation in the form of Axonics® Therapy might be your answer. Please reach out to the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas and schedule an appointment today to learn more about the treatment and find out if you’re a candidate.