If you’re taking medication for overactive bladder and still struggling, it can be incredibly frustrating. You may rush to the bathroom, wake up several times at night, or deal with leaks that interrupt your day. Even after trying different pills, adjusting fluids, and avoiding triggers, your bladder may still feel out of control.

When OAB medications stop working, it can feel like nothing will help. But there are treatments designed for people whose symptoms continue despite medication. One option that works for many people with OAB is sacral neuromodulation. This treatment can help you feel more in control and stop planning your day around the nearest bathroom.

What Is Sacral Neuromodulation?

Sacral neuromodulation is a treatment that uses gentle electrical signals to help the bladder work better. It improves communication between the bladder and the nerves that control when you urinate. These nerves are called sacral nerves. They’re located near the bottom of your spine, just above your tailbone.

Overactive bladder symptoms can happen when the bladder and brain are not sending clear signals to each other. This can lead to sudden urges or poorly timed trips to the bathroom. Sacral neuromodulation helps calm and steady these signals. Medical guidelines recommend this treatment for people who have not found relief with medications.

How is Sacral Neuromodulation Performed?

Before anything permanent is placed, there’s a provisional evaluation, or trial phase. One benefit of this therapy is that you can try it first, following these steps:

  • A lead, or thin wire, is placed near the sacral nerves
  • You wear an external device for a short period and track symptoms
  • You and your doctor review how well it worked. Then, you decide if the improvement is strong enough to move forward with permanent placement.

InterStim and Axonics are examples of sacral neuromodulation systems used to help control bladder symptoms. They are for people with overactive bladder who still have strong urges, frequent bathroom trips, urine leaks, or trouble emptying the bladder. This option is designed for people who have not gotten relief from medications or other basic treatments.

Permanent placement of the device is done in an operating room. Your doctor may use light sedation or general anesthesia. During the procedure, small cuts are made in the buttock area. The permanent wire and small device are placed under the skin, replacing the temporary test device.

Most people feel very little stimulation. Some do not feel it at all once the device is adjusted. The settings can be changed over time to improve comfort and bladder control.

InterStim and Axonics both offer a few different options. Some devices are rechargeable. Others do not need recharging. Some systems also allow full-body MRI scans under certain conditions.

Both InterStim and Axonics work in the same basic way. The best choice often depends on medical factors and lifestyle needs, including:

  • How you respond to the trial
  • Comfort with using a remote and checking settings
  • Need for device recharging
  • Occasional reprogramming visits

Next Steps When OAB Medications Stop Working

If overactive bladder symptoms are still affecting your daily life, it may be time to talk with a urologist about other treatment options. When medications no longer help, nerve-based therapies may be the answer.

If you live in the greater Charlotte, NC, or Columbia, SC areas, a urologist can help you explore your options and decide what comes next. You don’t have to keep planning your life around your bladder. Schedule a consultation to learn how treatment may help you feel more in control again.