Hospital Surgery · University Urology, PC
Sacral Nerve Stimulator Implant (Axonics)
Surgical expectation guide for permanent sacral neuromodulation device implantation — covering preparation, what to expect during surgery, and recovery instructions.
Your surgery date and arrival time
Your surgery date and arrival time are listed in the written instructions provided by our office. If you have any questions about your date, arrival time, or where to go, please contact our office at (865) 305-9254 or the pre-op RN directly at (865) 440-1579 to clarify before your surgery day.
Please refer to the driving & parking instructions
See Getting to UTMC for directions, parking, and registration instructions.
Pre-Anesthesia Testing
Pre-Anesthesia Consultation & Testing (PAT)
Before your surgery, you will have a Pre-Anesthesia Testing appointment at UTMC. This appointment ensures the day of surgery runs smoothly and safely.
What happens at your PAT appointment
- Full health history and physical exam
- Necessary lab work
- EKG and Chest X-Ray if age or medical conditions require
- Medication review — especially blood thinners and GLP-1 medications
What to bring
- Photo ID and insurance cards
- Complete medication list with dosages and timing (prescription and over-the-counter)
- Names and phone numbers of all specialists and your primary care physician
What to tell your doctor
- Any personal or family history of bleeding disorders or anesthesia reactions
Your PAT appointment date and time
Your Pre-Anesthesia Testing date and time are listed in the written instructions provided by our office. If you have any questions about your PAT appointment, please contact our office at (865) 305-9254 or the pre-op RN at (865) 440-1579.
Pre-Surgery Instructions
Medications & Fasting
Blood thinners
Stop as directed by your prescribing physician — typically 3–7 days before surgery.
- Plavix and Warfarin: Stop 7 full days before surgery (e.g., if surgery is Wednesday, stop after Tuesday’s dose the prior week)
- Xarelto and Eliquis: Stop 2 full days before surgery (e.g., if surgery is Wednesday, stop after Sunday’s evening dose)
GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound, etc.)
Stop 7 days prior to surgery.
SGLT-2 medications (Jardiance, Invokana, Farxiga, Brenzavvy, etc.)
Stop 3 days prior to surgery.
Herbal medications and supplements
Stop 7 days prior to surgery.
All other prescription medications
Continue unless directed otherwise. Take approved medications on the morning of surgery with a small sip of water.
Fasting Instructions
Nothing to eat or drink for 8 hours before your arrival time
This includes no gum chewing or hard candy. Follow this rule strictly — eating or drinking before surgery may require postponing your procedure.
Blood thinners: do not stop without contacting your prescribing provider
If you have been prescribed aspirin or blood thinners by a cardiologist or other physician, contact that provider before making any changes. Do not stop on your own. Examples include: Warfarin (Coumadin), Plavix, Lovenox, Xarelto, Eliquis, and over-the-counter aspirin. If your blood thinner cannot be stopped for the required timeframe, contact your surgeon to discuss.
Day of Surgery
Hygiene & Logistics
Hygiene
Shower the night before and the morning of surgery using an antibacterial soap. Do not use lotions, powders, or deodorant on the day of surgery.
What to bring
Photo ID, insurance card, and your complete medication list. Leave all valuables and jewelry at home — your driver will be responsible for belongings while you are in surgery.
Driver required
You must arrange for a responsible adult to drive you home. Public transportation and ride shares (Uber, Lyft, etc.) are not permitted unless accompanied by a responsible adult.
Surgery time may change
The time of your surgery may change. If your scheduled time changes, the facility will contact you. Please plan to be available for surgery at any time on your scheduled surgery date.
About the Procedure
How Axonics Sacral Neuromodulation Works
Axonics therapy works by delivering tiny electrical pulses to the sacral nerves via a miniature implanted device. These pulses help restore normal communication between the brain and bladder, which can result in significant improvement in urgency, frequency, and urinary incontinence symptoms.
This is the permanent implant — different from the PNE trial
If you completed an Axonics PNE trial and had a good response, this surgery places the permanent implant. The device remains in place long-term and is managed with an external controller.
Recovery
What to Expect After Surgery
Activity restrictions
Refrain from strenuous physical activity for 3 weeks after the procedure.
Incision and showering
You may shower immediately after surgery — gently pat the surgical site dry. Do not submerge the surgical site in water (no baths, swimming, or hot tubs) for 2 full weeks after surgery.
Follow-up visit
You will follow up with your provider approximately 2 months after the procedure for device assessment and programming.
Device support
A representative from the Axonics company will be in contact after surgery to help manage device settings and answer questions about using your external controller.
After Surgery
When to Call Your Doctor
Contact your care team if you experience any of the following after discharge:
Fever
Temperature over 102.0°F
Wound concerns
Redness, warmth, swelling, or drainage from the incision or surgical site
Breathing / chest
Shortness of breath or chest pain
After hours
Call (865) 305-9254 and follow prompts for the on-call provider. For emergencies, go to your nearest ER or call 911.
University Urology & UTMC Contacts
Questions About Your Sacral Nerve Stimulator Surgery?
Contact our office or message us through Klara. For day-of-surgery questions, call Leah directly at (865) 440-1579.