Chronic fecal incontinence is the main indication for this operation.
Sacral neuromodulation or InterStim is a two staged procedure. Both are performed in the operating room.
- Stage I (Lead placement and testing phase): The first stage or testing phase that involves the insertion of the lead using fluoroscopy (x-rays) in order to identify the correct position. The lead will be tested to ensure the proper reflexes are noted. Once completed, the lead is connected to an external neuromodulator. Over the next two weeks, the generator will be adjusted until the desired effects are achieved.
- Stage 2 (Permanent neuromodulator/battery placement): After a successful test phase (defined as greater than 50% improvement in symptoms), you will return to the operating room for placement of the permanent neuromodulator/battery. It will be placed through a small incision over the buttock.
Complications are typically low. However, with every procedure there are some risks including postoperative pain, intraoperative bleeding, infection, blood clots and damage to adjacent organs. Some of the risks specific to this procedure include:
- Lead migration, meaning the tip of the wire changed position, usually requires repeat surgery to re-position the lead.
- Temporary pain at the insertion site.
- Infection around the inserted device which will usually require removal.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission
- Carefully read through pre-operative information provided
Day before surgery:
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet
- Change into theatre attire, remove all valuable belongings
Approximately 30-45 minutes.
Duration of hospital stay:
- Usually 1 – 2 days
- Refrain from strenuous activities (incl. exercise) for at least 4 weeks post-operatively
Back to work:
- Sick leave required post-operatively is approximately 5 days in total
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.