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Sacral nerve stimulator insertion
- Can be done for both urge and passive incontinence - S3 foramina
- Can also be done for urology or gynae
- Insert the stimulator to the S3 foramina
- Prone
- LA +/- sedation
- Use II to identify SIJ - draw transverse line through inferior aspect SIJ
- Now draw two intersecting lines on each side to mark the medial aspect of S3 foramina
- II sideways, place needle at about 60 degree angle with skin to reach 1mm past the bone
- Use the axial plane of the superior-inferior line
- Skin entry point 2cm above transverse line
- Aim for the curved soft tissue interface with bone
- Confirm position - look for billowing, anal wink, toe flexion
- Seldinger technique to place wire, then remove wire part so it goes floppy
- Then can either tunnel to battery or place on skin as test wire
