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Axonics Sacral Neuromodulation System

Axonics (now Boston Scientific, acquired 2024) introduced the first rechargeable sacral neuromodulation (SNM) system with long-term battery life and MR-conditional labeling — breaking Medtronic's decades-long SNM monopoly and driving rapid iteration in the field.

Device Family​

Axonics r-SNM (2019)​

  • Rechargeable IPG with 15-year expected device life
  • 5 cc volume (considerably smaller than InterStim II)
  • Patient recharges periodically (every 1–2 weeks, ~1 hour)
  • Full-body 1.5T and 3T MR-conditional (FDA-approved 2019/2020)

Axonics F15​

  • Recharge-free variant
  • Battery life 17.6 years at 1 mA, >20 years at lower settings
  • 20% smaller than Medtronic InterStim X
  • Ended the rechargeable-vs-recharge-free trade-off — you can have either

Axonics R20​

  • Longest recharge interval in SNM — 20+ year lifespan, infrequent recharging
  • Designed for patients who want both small form factor and extremely long life

Shared Platform Features​

  • Tined lead compatible across the Axonics IPG family
  • Smart patient remote and app-based programming
  • MR-conditional 1.5T / 3T full-body
  • Same indication profile as Medtronic InterStim

Indications​

Identical to the Medtronic InterStim family:

  • Urgency urinary incontinence (UUI)
  • Non-obstructive urinary retention
  • Urgency-frequency
  • Fecal incontinence

Clinical Effectiveness​

Equivalent to InterStim II in head-to-head and registry data. Axonics' clinical differentiation is the device experience (rechargeable options, smaller form factor, longer battery) rather than superior efficacy.

Choosing Axonics vs Medtronic​

FeatureMedtronicAxonics
Smallest IPGInterStim Micro (17 × 47 mm)r-SNM (~30 × 40 mm)
Recharge-freeInterStim II, InterStim XF15, R20
RechargeableInterStim Micror-SNM
Longest recharge-free batteryInterStim X (~15 yr)F15 (17.6+ yr) / R20 (20+ yr)
MR-conditional1.5T/3T (2020)1.5T/3T (2019/2020)
Acquired by(independent)Boston Scientific (2024)

Neither is universally "better" — selection is driven by patient preference (recharge vs no-recharge), anatomy (pocket size constraints), and surgeon / center experience.

See also: Medtronic InterStim, eCoin, Revi System.