# Axonics SNM for Urgency Urinary Incontinence: A Complete Guide
*Physician-developed guide by the bladder specialists at BladderCenter of Arizona*
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## Introduction: When Urgency Urinary Incontinence Takes Over Your Life
Urgency urinary incontinence (UUI) is more than an inconvenience — it\’s a condition that quietly reshapes daily life. You plan every outing around bathroom locations. You wake two, three, four times each night. You decline invitations, limit travel, and live with the persistent anxiety of an accident that can happen at any moment. If this sounds familiar, you are not alone.
More than 13 million Americans live with urgency urinary incontinence, yet fewer than half seek treatment. Many accept it as a normal part of aging or believe nothing can truly help. The good news is that medicine has advanced dramatically. Today, **Axonics sacral neuromodulation (SNM)** offers a clinically proven, minimally invasive solution for patients who have not responded to lifestyle changes or medication — and the results are life-changing.
This guide will walk you through everything you need to know: what urgency urinary incontinence is, how sacral neuromodulation works, what the Axonics device specifically offers, who is a candidate, and what outcomes you can realistically expect.
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## What Is Urgency Urinary Incontinence?
Urgency urinary incontinence is defined as the involuntary leakage of urine that is accompanied by or immediately preceded by a sudden, intense urge to urinate. It is one component of **overactive bladder (OAB)**, a broader syndrome that includes:
– **Urgency:** A sudden, compelling urge to urinate that is difficult to defer
– **Frequency:** Urinating more than 8 times per 24 hours
– **Nocturia:** Waking to urinate 2 or more times per night
– **Urgency incontinence:** Leakage that accompanies or follows an urgent urge
UUI occurs when the detrusor muscle — the smooth muscle of the bladder wall — contracts involuntarily before the bladder is actually full. This is called **detrusor overactivity**, and it is driven by miscommunication between the sacral nerves (which regulate bladder function) and the central nervous system.
### Why Standard Treatments Often Fall Short
First-line treatments for urgency urinary incontinence include:
– **Behavioral therapy:** Bladder retraining, timed voiding, pelvic floor exercises
– **Anticholinergic medications:** Oxybutynin, tolterodine, darifenacin, solifenacin
– **Beta-3 agonists:** Mirabegron (Myrbetriq), vibegron (Vibegron)
These treatments help many patients, but a significant subset — estimated at 40 to 60% — does not achieve satisfactory improvement. Anticholinergic medications carry side effects including dry mouth, constipation, cognitive fog, and urinary retention. Many patients discontinue within the first three months. When conservative measures fail, sacral neuromodulation becomes the next clinical consideration.
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## How Sacral Neuromodulation (SNM) Works
Sacral neuromodulation is a **neuromodulation therapy** — it modulates the neural signals that control bladder function rather than chemically blocking receptors or cutting tissue. The therapy works by delivering mild electrical impulses to the sacral nerve, specifically the S3 sacral nerve root, which directly controls bladder, sphincter, and pelvic floor function.
By providing consistent, targeted stimulation to the S3 nerve, SNM effectively:
1. **Interrupts the abnormal neural signals** that trigger involuntary detrusor contractions
2. **Restores balanced signaling** between the bladder and the brain
3. **Reduces urgency and frequency** by recalibrating the voiding reflex threshold
4. **Decreases leakage episodes** by reducing the uninhibited contractions that cause UUI
Crucially, SNM is **reversible and adjustable**. The stimulation can be turned off, adjusted, or the device can be removed. Patients do not need to commit permanently — and the therapy can be trialed before any permanent implant is placed.
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## The Axonics SNM Device: What Sets It Apart
The Axonics SNM system is the newest generation of sacral neuromodulation technology, and it represents a significant advancement over older devices. For patients considering SNM for urgency urinary incontinence, the specific device matters — and here\’s why Axonics is the preferred choice at BladderCenter of Arizona.
### 1. Full-Body MRI Compatibility
Axonics was the **first sacral neuromodulation device approved for full-body MRI compatibility at 1.5 Tesla and 3 Tesla** under standard conditions. This is a major clinical advantage. Patients who need MRI scans — a common diagnostic tool for neurological, musculoskeletal, and oncological conditions — can undergo imaging safely without requiring device explantation. Older first-generation devices could not offer this.
### 2. Rechargeable, Long-Life Battery
The Axonics device features a **rechargeable battery system** with a lifespan of 15 or more years. Charging takes approximately 30 minutes and is done via a small external charger worn over the implant site — most patients charge once every 1 to 2 weeks while relaxing. This eliminates the repeat surgeries required for battery replacement that older devices necessitated every 3 to 5 years.
### 3. Small, Comfortable Form Factor
The Axonics implant is approximately the size of a USB thumb drive — significantly smaller than legacy devices. Its compact profile means less discomfort at the implant site, improved patient satisfaction, and fewer issues with migration.
### 4. Patient-Controlled Remote
Patients manage their therapy via an intuitive, phone-sized remote control. Stimulation levels can be adjusted for daily comfort, and the device can be paused during activities where stimulation is not needed. Connectivity with the physician\’s office allows remote programming adjustments in many cases.
### 5. Proven Clinical Outcomes
In the **ARTISAN-SNM clinical trial**, 89% of Axonics patients with overactive bladder demonstrated therapeutic success at 3 months, defined as ≥50% reduction in urgency incontinence episodes or ≥50% reduction in daily urgency episodes. At 3 years, 94% of patients with implanted devices maintained therapeutic success. These are durable, clinically significant results.
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## Who Is a Candidate for Axonics SNM?
Axonics sacral neuromodulation is indicated for patients who:
– Have a diagnosis of **urgency urinary incontinence, urgency-frequency syndrome, or non-obstructive urinary retention**
– Have **failed or been unable to tolerate** at least one prior conservative treatment (medication, behavioral therapy, pelvic floor PT)
– Do not have a structural or anatomical cause of their bladder dysfunction that requires surgical correction
– Are able to understand and operate the external charging and remote system
– Are not pregnant (pregnancy is a contraindication to active SNM therapy, though devices may be placed between pregnancies)
**Who may not be a good candidate:**
– Patients with a primary stress urinary incontinence diagnosis (SNM is not indicated for pure stress incontinence)
– Patients with neurological conditions that have caused complete sacral nerve denervation
– Patients with active urinary tract infection at the time of evaluation
– Patients who are unable to cooperate with the staged trial process
The evaluation process at BladderCenter of Arizona includes a comprehensive urological history, post-void residual measurement, urinalysis, and often urodynamic testing to confirm detrusor overactivity and rule out other causes.
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## The Axonics SNM Procedure: What to Expect
The Axonics SNM procedure occurs in two stages, allowing patients to evaluate the therapy before committing to the permanent implant.
### Stage 1: The Evaluation Trial
A temporary lead wire is placed adjacent to the S3 sacral nerve under fluoroscopic guidance in a minimally invasive outpatient procedure, typically performed under light sedation or local anesthetic. The lead is connected to an external stimulator that the patient wears for **7 to 14 days**.
During the trial period, patients keep a bladder diary, tracking urgency episodes, leakage events, and frequency. A **50% or greater improvement** in symptoms is the threshold for proceeding to permanent implantation — and most patients exceed this threshold.
### Stage 2: Permanent Implantation
If the trial is successful, the permanent Axonics device is implanted in a second outpatient procedure under light sedation. The lead is permanently secured to the sacrum with a small tined anchor, and the pulse generator is placed in the upper buttock through a small incision. The procedure takes approximately 30 to 60 minutes.
**Recovery:** Most patients return to normal activities within 1 to 2 weeks. Heavy lifting and vigorous exercise are restricted for 4 to 6 weeks to allow lead stabilization. Most patients notice continued improvement in symptoms over the first 3 months as the therapy reaches optimal calibration.
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## Outcomes: What Results Can Patients Expect?
The clinical evidence for Axonics SNM in urgency urinary incontinence is among the strongest in the urology field:
– **89% therapeutic success rate** at 3 months (ARTISAN-SNM pivotal trial)
– **94% of implanted patients** maintained success at 3 years
– Average **73% reduction in urgency incontinence episodes** per day
– Significant improvements in quality of life scores, sleep quality, and social functioning
– **Durable results** that persist for the life of the device (15+ years with recharging)
Importantly, these outcomes represent patients who had already failed first-line treatments — patients for whom medications did not work or were not tolerated. SNM does not simply reduce symptoms; it often **eliminates them entirely**. Many patients report returning to activities they had given up for years.
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## Taking the Next Step
Urgency urinary incontinence is a treatable condition. You do not have to plan your life around bathroom access, set alarms at night, or carry a change of clothes everywhere you go.
BladderCenter of Arizona specializes in Axonics sacral neuromodulation and has performed more Axonics SNM procedures than any other practice in the region. Dr. Tory McJunkin is a board-certified interventional physician with advanced Axonics training and one of the highest procedure volumes in the country.
**If you have struggled with urgency urinary incontinence and medications have not given you the relief you deserve, it is time to ask about Axonics SNM.**
[Schedule a Consultation at BladderCenter.com](https://bladdercenter.com) — our team will review your history, answer your questions, and help you determine if you are a candidate for this life-changing therapy.
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*This article is for educational purposes and does not constitute medical advice. Please consult a qualified physician for personalized evaluation and treatment recommendations. BladderCenter of Arizona — board-certified specialists in bladder neuromodulation therapy.*
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**Tags:** axonics SNM, urgency urinary incontinence, sacral neuromodulation, overactive bladder treatment, UUI treatment, axonics device, SNM for incontinence, bladder neuromodulation, BladderCenter Arizona