Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
What Is Sacral Neuromodulation for Bladder Problems?
Sacral neuromodulation (commonly known by the brand name InterStim) is an advanced treatment for overactive bladder and urge incontinence. It involves a small device — similar to a pacemaker — implanted under the skin near the tailbone. The device sends gentle electrical impulses to the sacral nerves that control bladder function, essentially recalibrating the communication between your brain and bladder.
How It Works
The sacral nerves (specifically S3) carry signals between the brain and the bladder. In OAB, these signals are overactive — they tell the bladder to contract when it shouldn’t. Sacral neuromodulation modulates these signals, restoring more normal communication and reducing urgency, frequency, and urge incontinence.
Think of it as resetting the thermostat for your bladder. The signals telling your bladder to squeeze are set too low — the device adjusts them to a more appropriate level.
The “Try Before You Buy” Approach
One of the unique advantages of sacral neuromodulation is the two-stage process:
Stage 1 (Trial period): A thin wire is placed near the sacral nerve through a small needle. You wear an external device for 1-2 weeks to test whether the therapy works for you. During this time, you keep a bladder diary to objectively measure improvement.
Stage 2 (Permanent implant): If the trial shows significant improvement (typically 50% or greater reduction in symptoms), the permanent device is implanted in a brief outpatient procedure.
If the trial doesn’t provide adequate relief, the wire is simply removed — no permanent changes have been made.
Who Is a Candidate?
Sacral neuromodulation is typically recommended for women who:
- Haven’t responded adequately to behavioral therapy and medications
- Can’t tolerate medication side effects
- Prefer a long-term solution over repeated Botox injections
- Have urge incontinence, OAB, or difficulty emptying the bladder
Results
- 70-80% of patients who respond to the trial period maintain long-term success
- Significant reductions in urgency episodes, frequency, and incontinence
- Battery life of approximately 15 years with newer rechargeable models
- Fully reversible — the device can be removed if desired
What I love about sacral neuromodulation is the trial period. You get to experience the therapy before committing to anything permanent. If it works — and for most patients who go to trial, it does — it provides continuous, long-term relief.
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