The implantable device — about the size of a wristwatch — is place under the skin in the upper right buttock. It is connected to a small wire that sits near the sacral nerves, which help control the bladder and bowel.

By gently stimulating these nerves, the device helps regulate the signals between the brain and pelvic organs. The goal is to restore more normal bladder and/or bowel function and improve quality of life for your child.

Before

The first step is a test period to see if sacral neuromodulation will help your child. During this stage, we check if their symptoms — like urinary or bowel accidents — get significantly better. Our goal is at least a 50% improvement. If the test is successful, we may move forward with placing a long-term device.

During

The procedure is done while your child is asleep under anesthesia and usually takes one to two hours. It is an outpatient procedure, so your child can go home the same day.

What Happens

• A small wire (called a lead) is placed near the sacral nerves in your child’s lower back.
• This wire connects to a small, temporary device that stays outside the body but is easily hidden under clothing.
• The area where the wire exits the body will be covered with a bandage.

While the device is on, your child may feel a light buzzing sensation in the upper thigh or private area. This feeling shouldn’t hurt, and most kids get used to it quickly.

After

The evaluation period usually lasts about two weeks. During this time, your child can go to school or work as usual but should take it easy. That means:

• No heavy lifting
• No strenuous exercise
• No bending or twisting too much

You’ll have access to our care team 24/7 in case you have any questions or concerns.

Tracking Progress

You and your child will be given easy-to-use tools (like diaries or symptom trackers) to keep track of:

• Urinary symptoms (like leaks or accidents)
• Bowel symptoms (like constipation or accidents)

These tools help us measure if the device is making a positive difference.

What Happens Next

• If the device helps, we’ll talk about moving to a permanent implant.
• If it doesn’t help enough, the internal wire will be removed with a short outpatient procedure (your child will be asleep under anesthesia). We’ll then look into other treatment options together.

Second Stage: Permanent Implant

If your child shows at least 50% improvement in urinary and/or bowel symptoms during the trial phase, they can move on to the second stage.

What Happens

• Your child will have another outpatient procedure under anesthesia.
• The lead (wire) and the device will be implanted permanently under the skin in the upper right buttock.
• The device is small (about the size of a watch) and won’t be noticeable when your child moves or sits.

How Long Does the Device Last

• The battery lasts around 10 years.
• If your child still needs it after that, it can be replaced under anesthesia.

Benefits of Sacral Neuromodulation

• Can greatly improve or eliminate symptoms when other treatments (like medications or behavioral therapy) haven’t worked
• The therapy can be stopped at any time by turning the device off
• Doesn’t need to be replaced as your child grows
• May continue to help into adulthood

Risks

Like any surgery, this procedure carries some risks, such as:

• Swelling
• Bruising
• Bleeding
• Infection

Your care team will talk to you about how we minimize these risks and what to watch for during healing.

Travel and Ongoing Care

• The device does not trigger airport alarms.
• Your child will receive an ID card to carry and can get a medical alert wristband, if you choose.
• If your family moves, there are many experienced providers around the world familiar with this treatment.
• Follow-up care is easy to arrange wherever you are.

Expert care. Our team provides treatment for urinary, fecal or combined incontinence in children when other treatments have not worked or when families are seeking an alternative option.

Large, multidisciplinary team: We are a multidisciplinary team made up of specialists from urology and gastroenterology. Each team member brings unique expertise to provide a comprehensive evaluation and treatment plan for your child. Our recommendations are personalized for each patient and may include additional options such as medications or behavioral therapies, which we also offer.