I think there are a lot of good candidates for Sacral Neuromodulation—in fact, a great deal more than we usually think about. Many view Sacral Neuromodulation as the last option, as the treatment you offer if everything else fails. My view is just the opposite. I move a patient onto Sacral Neuromodulation earlier, recognizing the high efficacy, understanding the long-term data, and knowing the great satisfaction this therapy provides for patients.
I personally view Sacral Neuromodulation as a restorative therapy, while I view the other therapies as basically destructive or obliterative therapies. If I want a paralytic agent, Botox is the choice. But more often I want something that creates more sound out of the symphony, that allows all the sections to work together and allows everything to come up to its natural potential; then Sacral Neuromodulation is the choice. And that’s the difference.
The fact that there is a trial with Sacral Neuromodulation I think is the greatest, you might say, safety valve in this whole process. And that means that I always tell patients you’re not committing to this for 5 years; you’re committing to it for 2 weeks and they get to evaluate whether or not the therapy is right for them. This is very empowering for patients.
What we have with the new Axonics System is a better way to help. The device is smaller, physically fits in their body much more easily, and the patient remote is very easy and intuitive to use. I think it’s a more dynamic, patient-friendly therapy option that fits better with most of my patients.
With the Axonics product, you might say it’s using smart technology to constantly adjust and to make up for that change in resistance in the body tissue to provide the exact degree of stimulation that a patient needs.
The quality of life improvement has been dramatic, and it’s been fast. Of the patients that I’ve worked with so far, with the Axonics product I would say that within a week or two these patients were already seeing huge improvements in their quality of life. And it appears, as we’re following them, that improvement has continued to increase even further with time.
We’ve had a number of patients who have come in who have been profoundly affected by it—people who wanted to be physically active, people who wanted to go back to running, people who want to do things with their family, people who want to take trips. All of the things that mean stuff to us in life, they are resuming those things. And most importantly they are having confidence to do it.