An overactive bladder is a condition that causes a frequent and urgent need to urinate. Some people with this condition experience urinary incontinence, or the involuntary leakage of urine.
Sacral nerve stimulation, or sacral neuromodulation, is a potentially effective treatment option. It involves implanting an electrode under your skin to stimulate the nerves around your bladder with electricity.
This electricity inhibits signals traveling from your bladder to your spinal cord and brain, potentially reducing symptoms of an overactive bladder and some other health conditions.
Sacral nerve stimulation is most often recommended when you do not respond to earlier treatment options, such as:
- lifestyle changes and exercises to strengthen your pelvic floor muscles
- oral therapies
- bladder Botox injections
Read on to learn more about how sacral nerve stimulation can help treat an overactive bladder.

Illustration by Sophia Smith.
An overactive bladder is a common condition that affects about
Sacral nerve therapy gained approval from the Food and Drug Administration (FDA) in
- urinary incontinence, or involuntary leakage of urine
- urinary retention
- frequent urination
- fecal incontinence, or involuntary leakage of feces
- chronic constipation (in Canada and Europe)
Sacral nerve stimulation works by stimulating the nerves that send electric signals back and forth from your brain and bladder.
Researchers are still examining the exact action of sacral nerve stimulation, but the
These sensory nerves can become overactive due to some neurological conditions or inflammatory disorders. The most commonly stimulated area is the root of your
In a
People receiving sacral nerve stimulation had a 76 percent success rate compared to 49 percent in the control group over 6 months. Success was defined as a greater than 50 percent improvement in symptoms.
Sacral nerve stimulation may help people avoid the potential side effects of more invasive procedures, such as a surgery called augmentation cystoplasty.
Other
- improving involuntary urine leakage
- decreasing the number of times you need to urinate per day
- improving your maximum bladder capacity
- reducing urinary retention
- improving quality of life
Sacral nerve stimulation may also help people with fecal incontinence manage their symptoms.
About
In a
The procedure can be expensive, and surgical correction may be needed if problems arise. Correction can add to the overall cost. It usually consists of relocating the device due to pain or changing the location of the wire if it migrates.
In a
Other potential complications of sacral nerve modulation include:
- infection
- electrical shock
- device malfunction
- postoperative hematoma (bruising)
- discontinued benefit
An electrode that looks similar to a pacemaker will be implanted under your skin with wires connected to nerves around your bladder. Before the procedure, you’ll go through an evaluation or test phase to see if the device is effective for you.
Evaluation phase
To see if your body will respond to sacral nerve stimulation, you’ll be given a temporary device. A medical professional will insert a wire through your skin near your tailbone and connect it to your sacral nerves. The wire is connected to a small battery-operated device that’s worn on a belt.
This phase typically lasts about 2 or 3 weeks. In a
Among people who did not have success after the first week, 42 percent had an improvement in symptoms after reprogramming.
Implant phase
If your evaluation phase is successful and your doctor thinks you’ll make a good candidate, you’ll be offered an implant. A greater than
The small implant is placed beneath your skin in your upper buttocks with a wire connected to your sacral nerves. If your initial test is not successful, your doctor will either remove the wire or recommend repeating the evaluation.
Sacral stimulation may be an option if you have not found success with more conservation treatment options, such as:
- behavioral changes
- exercises
- biofeedback
- medications
Your doctor can let you know if they think sacral nerve stimulation will help you. Some people may not make good candidates, such as people:
- with urinary obstructions
- with current pelvic infections
- with severe or rapidly progressive neurological diseases
- who are
over age 55 and have three or more long-term health conditions - who do not respond to the evaluation phase
- who are undergoing magnetic resonance imaging (MRI), although
MRI-safe devices are now being introduced in the United States.
It’s
Is it covered by insurance?
Many insurance companies cover sacral nerve stimulation in people who do not respond to more conservative treatments or who do not make good candidates for other treatments.
For example, Medicare plans supported by Blue Cross North Carolina cover sacral nerve stimulation when used to treat urinary urge incontinence. To qualify, you must show a 50 percent improvement in the evaluation phase and meet other candidacy requirements.
Sacral nerve stimulation is a procedure that involves placing an electrode under your skin to stimulate the nerves that send messages between your brain and bladder.
It may be an effective option if more conservative treatments have failed. You can discuss this procedure with a doctor to see if it’s right for you.
Before receiving an implant, you’ll be given the opportunity to have a short trial to see if it’s effective.