Concierge functional urology · UK
Sacral nerve stimulation - the test-first pathway.
A tined-lead test phase before any permanent implant. If the diary shows real benefit, we implant an InterStim or Axonics device - MRI-conditional, rechargeable or not, matched to your case.
Why patients choose us
- 01
A urologist or coloproctologist doing SNS weekly
You are matched to a consultant whose weekly list includes SNS test-phase leads and permanent implants - high SNS volume drives outcomes.
- 02
A proper two-stage test first
A tined-lead percutaneous nerve evaluation (PNE) or full test phase before any permanent implant. No blind commitment to hardware.
- 03
Independent, and free
We take no fee from device manufacturers. If Botox, TPTNS or surgery fits better, we say so.
Indicative pricing
What private SNS costs in the UK.
Two-stage pathway pricing - the test phase is priced separately from the permanent implant.
In short
Test phase and permanent implant together: £18,000–£26,000 across two visits.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| SNS test phase (tined lead + external stimulator) | £4,000–£6,500 | 45–75 min | Day-case |
| SNS permanent implant (device + generator) | £14,000–£20,000 | 45–90 min | Day-case or 1 night |
| Rechargeable SNS device upgrade | Additional £2,000–£3,500 | 45 min | Day-case |
| Battery replacement (5–7 years) | £4,000–£6,500 | 30–45 min | Day-case |
| Programming visit | Included first 12 months | 20–30 min | Same visit |
| Consultant urology / coloproctology assessment | £300–£500 | 30–45 min | Same visit |
Prices depend on device (rechargeable or not), platform (InterStim, Axonics) and hospital. Battery replacements are surgical procedures with their own cost.
The problem
Prove it works before you keep it.
SNS is a good operation for the right patient. The two-stage pathway makes sure you are the right patient before we ask you to keep hardware for life.
Diary-driven decision
The bladder or bowel diary during the test phase makes the decision - not the sales pitch.
Named consultant, both stages
The same surgeon who places the lead does the permanent implant. Continuity matters.
Programming is a service, not an afterthought
A nurse specialist who knows your device and your case handles programming for the life of the device.
The journey
From enquiry to permanent implant - what happens, in order.
Two visits, one team, and years of follow-up.
Phase 1 · Before
Diary, urodynamics, consent
Phase 2 · On the day
Test lead, implant
Phase 3 · After
Programming, annual review
- 01
Before
You describe the problem
Urgency, frequency, incontinence, non-obstructive retention, faecal incontinence or constipation. Bladder diary and any prior treatments.
- 02
Before
We come back with a plan
Within one working day: whether SNS fits, which consultant, and an indicative price for test phase and permanent implant.
- 03
Before
Urodynamics or anorectal physiology
Objective testing to confirm the indication and rule out obstruction or fixed structural disease.
- 04
On the day
Test phase - tined-lead placement
Prone under local anaesthetic with light sedation, fluoroscopic S3 foraminal placement, a tined lead is left in place and connected to an external stimulator for two to four weeks.
- 05
On the day
Test-phase diary
You keep a bladder or bowel diary at home. A 50 percent or greater improvement is the standard threshold to proceed.
- 06
On the day
Permanent implant
If the test is positive, the same lead is connected to a rechargeable or non-rechargeable pulse generator placed in an upper buttock pocket under local anaesthetic and sedation.
- 07
After
Programming and follow-up
Programming at two weeks, review at three months, then annually. Battery lasts 5 years (non-rechargeable) or 15 years (rechargeable).
Test phase to permanent implant: 3–5 weeks. First programming: 2 weeks after implant.
When it helps
Where SNS earns its keep.
The functional indications that respond, plus the red flag that means neurology, not neuromodulation.
Refractory overactive bladder
Urgency and urge incontinence unresponsive to antimuscarinics, mirabegron and pelvic-floor physiotherapy.
Non-obstructive urinary retention
Difficulty emptying without a mechanical obstruction, often idiopathic - SNS improves voiding efficiency in most responders.
Faecal incontinence
Passive or urge faecal incontinence unresponsive to conservative measures - a major indication in UK coloproctology.
Interstitial cystitis / bladder pain syndrome
Selected patients gain useful symptom modulation from SNS after simpler measures have failed.
Constipation with rectal evacuation difficulty
A selected group with slow-transit or evacuation-disordered constipation benefit - a specialist workup guides selection.
Fowler’s syndrome
Young women with non-obstructive urinary retention from a hypertonic urethral sphincter - SNS is the treatment of choice.
Post-obstetric faecal incontinence
When primary sphincter repair has failed or is not offered, SNS is a good next step.
Red flag: new neurological deficit
Progressive neurological symptoms, new leg weakness or saddle numbness need urgent MRI and neurology - not an SNS clinic.
Options
Devices, tests and alternatives.
SNS options plus the non-implant alternatives worth considering first.
Tined-lead test phase
The modern UK standard - a permanent-style lead placed under fluoroscopy and connected to an external stimulator for two to four weeks. Higher predictive value than PNE.
PNE (percutaneous nerve evaluation)
A quick, temporary wire test done under local. Cheaper but less predictive and less able to test bowel symptoms.
Medtronic InterStim
The dominant UK platform. Non-rechargeable (InterStim II, ~5 years) and rechargeable (InterStim Micro, ~15 years) options. MRI-conditional.
Axonics rechargeable SNS
A newer rechargeable device with a smaller footprint and long battery life - increasingly used in UK centres.
Botulinum toxin injection
A useful alternative for overactive bladder - cheaper, needs re-injection every 6–9 months, self-catheterisation risk in a minority.
Transcutaneous posterior tibial nerve stimulation (TPTNS)
A non-invasive neuromodulation option - twelve weekly clinic sessions and monthly maintenance.
Anterograde enema (ACE) for bowel
Structural bowel-management surgery for a subset with severe constipation.
Sphincteroplasty or artificial bowel sphincter
For structural sphincter defects, where repair rather than neuromodulation is the primary answer.
Our vetted UK network
SNS implanters and nurse programmers, we picked them.
Consultant urologists and coloproctologists with high-volume SNS practice across London, Manchester and Birmingham.
Selection criteria
How we choose every SNS team in our network.
Consultants delivering at least 30 SNS implants per year with published outcomes
Two-stage tined-lead test as standard - not PNE alone
Nurse specialist embedded for programming and troubleshooting
Annual device review with battery life estimate and MRI safety review
Safety and recovery
What to expect afterwards - honestly.
SNS is generally very well tolerated. The things worth planning are MRI needs, battery life and future pregnancy.
Test phase is the safety net
You commit to a permanent implant only after a 50 percent or greater diary improvement in the test phase. That is the whole point of doing it that way.
Lead migration
Small, gradual movement of the lead is the commonest cause of loss of effect - usually correctable by reprogramming rather than reoperation.
Infection
Pocket or lead infection is under 3 percent. Usually needs device removal, treatment, and re-implantation after a clean interval.
Pain at the pocket
Discomfort around the generator settles for most. A small revision moves the generator if it stays uncomfortable.
Loss of effect over time
Around 10–20 percent of patients lose effect after a few years and need reprogramming, lead revision or acceptance.
MRI compatibility
All current SNS devices in UK use are MRI-conditional - you can have MRIs with specific settings, but check with the device team every time.
Pregnancy
SNS is turned off during pregnancy. Discuss timing with the team before conception if possible.
Battery replacement
Non-rechargeable battery: replaced surgically every 5–7 years. Rechargeable: home charging weekly, replacement every 15 years.
Red flags after implant
Fever, spreading redness or discharge at the site, new leg weakness or bladder or bowel change: same-day team or A&E.
Reading your notes
Your operation note in four parts. Read the last one first.
Keep the device serial number and MRI conditions with you - you will need them for years.
A quiet reminder
Bring the device card to every hospital visit.
Model, serial and current programme - that card saves an hour every visit.
- 01Header
Device, lead position and side
Which platform (InterStim or Axonics), lead placement (S3 foraminal, side), and generator model.
- 02Technique
Fluoroscopy and thresholds
Sensory and motor thresholds recorded during placement, along with the four-electrode configuration used.
- 03Findings
Test-phase diary result
Percentage improvement in urgency episodes, incontinence episodes or bowel events during the test.
- 04Impression
Programme, review and MRI notes
Read this first: programme settings, next review date, MRI-conditional parameters, and battery estimate.
Recognised by major UK insurers
SNS is covered by most UK insurers once conservative options have been exhausted. We check cover in writing before booking.
Frequently asked
Everything we get asked about SNS.
Quick answers on tined-lead testing, InterStim vs Axonics, MRI and cost.
What is sacral nerve stimulation?
A thin electrical lead is placed through the S3 sacral foramen close to the sacral nerve. Gentle electrical pulses modulate the neural signalling to and from the bladder, bowel and pelvic floor. It is delivered in two stages - a test phase to confirm response, then a permanent implant if the test succeeds.
How well does the test phase predict permanent success?
A tined-lead test with a 50 percent or greater improvement in your diary predicts long-term response in around 70–80 percent of cases. A negative test rules SNS out - that alone is worth knowing.
Is SNS the same as sacral neuromodulation?
The terms are used interchangeably. Sacral neuromodulation is the umbrella term; sacral nerve stimulation is the SNS device that delivers it. Our sacral neuromodulation page covers the wider treatment context and device-selection decisions in more depth.
How much does SNS cost privately in the UK?
Roughly £4,000–£6,500 for the tined-lead test phase, £14,000–£20,000 for the permanent implant including device, and £4,000–£6,500 for a battery replacement. Most UK insurers cover SNS after pre-authorisation once conservative options are exhausted.
What is the difference between InterStim and Axonics?
InterStim (Medtronic) is the market leader with a non-rechargeable (~5 years) and a rechargeable Micro variant. Axonics offers a smaller rechargeable device with a 15-year battery. Both are MRI-conditional and clinically comparable - the operator’s experience with the platform matters most.
Can I have an MRI with an SNS device?
Yes - all current UK-implanted SNS devices are MRI-conditional. Specific settings and, sometimes, temporary deactivation are needed. Always tell the MRI department about the device and check with your SNS team before the scan.
Related treatments
Looking for something else?
Sacral neuromodulation
The wider neuromodulation decision guide.
Learn moreNeuromodulation
Neuromodulation across indications.
Learn moreNeurogenic bladder & bowel
Comprehensive management.
Learn moreSacral nerve root injection
Diagnostic image-guided root block.
Learn moreProlapse repair
For pelvic organ prolapse.
Learn moreAll tests & procedures
Every test and procedure we arrange.
Learn more