Bladder Control · University Urology, PC · Knoxville, TN
Sacral Neuromodulation — The Axonics System
Advanced therapy for overactive bladder, urge incontinence, urinary retention, and fecal incontinence — when conservative treatments haven’t been enough.
About SNM
How Sacral Neuromodulation Works
Sacral neuromodulation (SNM) delivers mild, continuous electrical stimulation to the sacral nerves that control bladder and bowel function. By modulating the communication pathways between the brain and bladder, SNM can restore normal voiding patterns in patients who have not responded to medications or behavioral therapy.
The Axonics system is a small, rechargeable implant placed near the tailbone. It is MRI-compatible, long-lasting, and can be adjusted non-invasively. A trial period confirms benefit before permanent implantation.
Indications: Refractory overactive bladder, urge urinary incontinence, non-obstructive urinary retention, and fecal incontinence. Patients must have failed or been unable to tolerate at least one conservative therapy.
Axonics System
Key Features
Full-body 1.5T and 3T MRI compatible — you won’t have to avoid imaging.
Battery designed to last 15+ years. Charges wirelessly — no repeated surgeries for battery replacement.
Remote-controlled by the patient for daily adjustments. Settings can be modified non-invasively.
Implanted at UTMC as an outpatient procedure. Most patients go home the same day.
The Process
PNE Trial Then Permanent Implant
SNM is a two-stage process. The trial confirms that stimulation provides meaningful benefit before you commit to the permanent implant.
Stage 1 — PNE Trial
A temporary lead is placed near the sacral nerve under local anesthesia in the office. You wear an external stimulator for 1–2 weeks and track symptoms in a voiding diary. If you achieve at least 50% improvement in your symptoms, you proceed to permanent implantation.
- Performed in-office under local anesthesia
- No MRI during trial period
- Voiding diary required before and during trial
- Full prep instructions at our PNE trial prep page
Stage 2 — Permanent Implant
A small rechargeable device is implanted near the tailbone at UTMC as an outpatient procedure. The permanent lead is placed under fluoroscopic guidance for optimal positioning.
- Outpatient procedure at UTMC
- General or sedation anesthesia
- Avoid heavy lifting and bending for 4–6 weeks post-implant
- Return to light activity within a few days
- MRI-compatible immediately after implant
Who Is a Candidate?
- Refractory overactive bladder or urge incontinence
- Non-obstructive urinary retention
- Fecal incontinence
- Failed or intolerant of medications and conservative therapy
- Willing and able to manage the external device during trial
Who Is Not a Candidate?
- Bladder outlet obstruction or stress-predominant incontinence
- Neurologic conditions affecting sacral nerve function (some exceptions)
- Active urinary tract infection
- Pregnancy or planning pregnancy
- Unable to operate the patient programmer
Axonics Content
Learn More From Axonics
The interactive resource below provides additional information about the Axonics therapy directly from the manufacturer.
Ready to Discuss Sacral Neuromodulation?
We offer the full SNM process — PNE trial through permanent implant — at University Urology.