🚽 Sacral Neuromodulation Simulator

Percutaneous Test Lead Placement at the Sacral Foramen

A temporary lead is inserted near S3 to test patient response.

• S3: Target nerve root (sacral foramen)
• 3–14 days: Trial duration (outpatient test)
• ≥50%: Response threshold (symptom improvement)
• Local: Anesthesia (awake sensory testing)

Placement procedure

Placeholder: needle guided fluoroscopically into the S3 foramen.

Delivering Controlled Electrical Pulses to the Sacral Nerve

The lead delivers tunable low-amplitude electrical pulses.

• 210 µs: Pulse width (typical setting)
• 14 Hz: Frequency (standard programming)
• 0–10 V: Amplitude range (patient titrated)
• Mild tingle: Sensation goal (perineal/vaginal area)

Stimulation parameters

Placeholder: amplitude titrated until comfortable motor/sensory response.

Modulating the Bladder-Spinal Cord Voiding Reflex Arc

Stimulation normalizes abnormal afferent bladder signaling.

• Sacral: Reflex arc (S2–S4 micturition center)
• Dampened: Afferent effect (urgency signaling)
• Neuromodulation: Mechanism (not ablation)
• Days–weeks: Onset (gradual improvement)

Reflex normalization

Placeholder: pulses recalibrate bladder-brain signal traffic.

Permanent Implantable Pulse Generator Placement

A battery-powered generator is implanted after trial success.

• ~5–15 yrs: Device life (battery dependent)
• Upper buttock: Implant site (subcutaneous pocket)
• ≥50% trial gain: Eligibility (response criterion)
• Outpatient: Procedure (minor surgery)

Permanent placement

Placeholder: generator connected to the successful trial lead.

Sustained Symptom Control With Chronic Neuromodulation

Long-term stimulation maintains reduced urgency and leakage.

• ~70–80%: Success durability (at 5-year follow-up)
• Major: Symptom reduction (urgency/frequency)
• As needed: Reprogramming (noninvasive adjustment)
• Fully: Reversibility (device removable)

Chronic outcomes

Placeholder: durable symptom control sustained over years.

Placeholder: most successful trials keep long-term benefit.