If you've been struggling with bladder or bowel control issues for a while, you've probably heard your doctor mention the axonics stage 1 procedure as a potential next step. It's essentially a "test drive" for a technology called sacral neuromodulation. Instead of jumping straight into a permanent implant, this first stage lets you and your doctor see if the therapy actually works for your body before making any long-term commitments.
It's completely normal to feel a bit nervous about any medical procedure, but this one is relatively straightforward. It's designed to be minimally invasive, and most people find the "trial phase" to be more of a minor inconvenience than a major ordeal. Let's break down what actually happens, why it's done, and how you can get the best results from your trial period.
Why Do the Trial Phase First?
You might wonder why you can't just get the whole thing done at once. The truth is, everyone's nervous system is a little different. While the Axonics system is incredibly effective for things like overactive bladder, urinary retention, and fecal incontinence, doctors want to be 100% sure it's going to help you specifically.
The axonics stage 1 procedure serves as a verification step. You'll wear an external stimulator for about a week or two. If your symptoms improve by 50% or more during that time, it's considered a success, and you can move forward with the permanent, internal implant. If it doesn't work, the lead is easily removed, and you haven't undergone a full surgery for something that wasn't the right fit.
Getting Ready for the Big Day
Preparing for the procedure is usually pretty simple. Your doctor's office will give you specific instructions, but generally, it's an outpatient thing. You'll go in, have the procedure done, and head home the same day.
Most people are told to wear loose, comfortable clothing. Think sweatpants or stretchy leggings—anything that won't rub too hard against your lower back where the trial lead will be placed. You might also be asked to fast for a few hours if they're using light sedation, though many doctors perform the axonics stage 1 procedure using just a local anesthetic to numb the area.
What Happens During the Procedure?
Once you're in the procedure room, you'll lie on your stomach. The doctor will numb a small area on your lower back, right above your tailbone. Using a thin needle and X-ray guidance (fluoroscopy), they'll place a thin, flexible wire—called a lead—near your sacral nerves. These are the nerves that act like a highway for signals between your brain and your bladder or bowel.
You won't feel any sharp pain, though you might feel some pressure. Once the lead is in the right spot, the doctor will usually test it by sending a tiny pulse of electricity through it. They'll ask you what you feel. Most people describe it as a "pulling," "tapping," or "fluttering" sensation in the pelvic floor area. It's not painful; it just feels a bit weird at first.
Once the doctor is happy with the placement, they'll secure the lead with some tape and medical adhesive. This wire stays under your skin, but the end of it exits the skin and connects to a small external stimulator. This little device is about the size of a pager, and you'll wear it on a belt or taped to your skin for the duration of the trial.
Living with the Trial Device
The next week or two is all about gathering data. You'll go about your normal life, but with one big addition: the "bladder diary." It sounds tedious, and honestly, it kind of is, but it's the most important part of the axonics stage 1 procedure.
You'll need to track how often you're going to the bathroom, any accidents you have, and how much urgency you're feeling. Your doctor needs to compare this diary to your "baseline" (how you were doing before the procedure). This is how they prove to insurance companies—and to themselves—that the device is doing its job.
Can You Shower?
This is the number one question everyone asks. Since the lead exits the skin and connects to an external battery, you generally cannot take a full bath or shower during the trial. You don't want to get the site wet, as it could cause an infection or mess with the electronics. Sponge baths are going to be your best friend for the next 7 to 14 days. It's a small price to pay for potentially fixing a long-term bladder issue, but it's definitely something to plan for.
What Does the Stimulation Feel Like?
The goal isn't for you to feel a constant "zap." In fact, after the initial setup, you might not feel the stimulation at all, or you might just feel a gentle pulse. The Axonics system is designed to work in the background. If the sensation becomes distracting or uncomfortable, you'll have a remote control to turn the intensity down.
Tips for a Successful Stage 1 Trial
To get the most out of your axonics stage 1 procedure, you have to be a bit careful with your physical activity. Since the lead is only held in place by some tape and a little bit of internal friction, it can shift if you're not careful.
- Avoid heavy lifting: Now is not the time to rearrange your living room furniture.
- No twisting or reaching: Try to avoid excessive bending at the waist. Think "log rolling" if you're getting out of bed.
- Be honest with your diary: Don't just write what you think the doctor wants to hear. If you had a bad day, record it. The more accurate the data, the better the final result will be.
- Keep the battery secure: Make sure the external controller is tucked away safely so it doesn't snag on a door handle or get pulled by a curious pet.
What Happens After the Trial?
After the designated trial period (usually 7 to 14 days), you'll head back to the office. The doctor will review your diary and chat with you about how you felt. If you saw a significant improvement—like going from 15 bathroom trips a day down to 6—you'll likely be cleared for Stage 2.
Removing the trial lead is a very quick process. It usually takes just a few seconds and feels a bit like having a bandage pulled off. Once the lead is out, your symptoms will likely return to their "normal" state until the permanent device is implanted.
If the axonics stage 1 procedure didn't provide enough relief, don't lose heart. Sometimes it's just a matter of lead placement, or perhaps a different type of therapy is better suited for your specific anatomy. But for the vast majority of people, this trial period is the light at the end of the tunnel.
Making the Decision
Deciding to go through with the axonics stage 1 procedure is a big step toward taking back control. It's a low-risk way to see if high-tech help is the answer to your symptoms. While the "no-showering" rule and the diary-keeping can be a bit of a hassle, most patients find that the clarity they gain about their health is well worth the temporary inconvenience.
If you're tired of planning your entire life around the nearest restroom, this trial is the best way to see if there's a permanent solution on the horizon. Just take it one day at a time, keep a good log of your progress, and stay in close contact with your medical team. You're one step closer to not having to worry about your bladder every second of the day.