Neuromodulation is a surgical technique that enables us to treat problems such as urinary incontinence via the permanent stimulation of the nerves that control the bladder.  A vesical pacemaker is not completely correct from a medical point of view, but it is a very descriptive denomination and very useful from a practical point of view, as both the professional and the patient quickly know what we are talking about.

The correct denomination is permanent Neuromodulation of sacrum roots in order to control urinary symptoms, namely: the permanent electrical stimulation of the nerves that control bladder function via the implantation of an electrical pulse generator (pacemaker).

A patient with urgent urine leaks (patient who doesn’t make it to the bathroom on time) and who does not respond to the conservative treatments we have available, quite effective in other patients, is given the option of Neuromodulation as an alternative to try and diminish the symptoms.  It consists in performing an initial test via the insertion of an electrode into the back at the level of the sacrum connected to an external stimulator which the patient controls during a short time, and during this time the response he or she is having to the stimulation is evaluated and if the response is significant, in other words if the patient significantly improves then he or she will be offered the definitive insertion of the pacemaker to provide permanent stimulation, both techniques are carried out under local anaesthetic, without requiring admission and with a rapid return to everyday activities.

The pacemaker inserted in the gluteal region, practically without leaving a mark, is controlled by the patient with an easily transportable control mechanism, and by the doctor via a programmer that permits the variation of the stimulation parameters, checking for faults or forecasting the durability of the internal pacemaker battery.

The use of the pacemaker to control the urinary bladder is approved in Europe and the United States, the most demanding of healthcare organisations, due to their safety of use and their short and long term effectiveness; and we are therefore obliged to offer this option to our patients in order to try and solve their problems.