Universität zu Köln

Karapanos, Leonidas, Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Kokx, Ruud, Schmautz, Maximilian and Heidenreich, Axel (2020). A rare case of tined lead migration of InterStim device into the rectum with subsequent novel combined surgical-endoscopic removal technique. Turk. J. Urol., 46 (6). S. 492 - 496. SISLI: AVES. ISSN 2149-3057

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Abstract

After the introduction of self-anchoring tined leads in 2002, lead migration after sacral neuromodulation (SNM) in the form of InterStim (TM) (Medtronic, Minneapolis, MN) has been reduced; however, it remains a considerable complication of this otherwise low-risk procedure. As intestinal perforation through lead migration or primary incorrect positioning portrays a rarity and has been scarcely reported in the literature, no algorithm for explantation in such cases has been determined. We present a case of a young man with an SNM device implant (InterStim II (R)) because of neurogenic urinary retention, who was admitted with inflammation, localized at the sacral lead insertion site. Our diagnostic algorithm revealed a tined lead electrode protruding into the rectum without concomitant abscess. We performed an interdisciplinary surgical approach combining regular incisions over the sacrum and buttocks for dissection of the lead and the implanted pulse generator, respectively, with an endoscopic transanal lead extraction. This method prevented further bacterial seeding in the surrounding tissues of the colon and, therefore, presacral abscess formation or sacral osteomyelitis. Combined surgical-endoscopic removal of the InterStim device is an effective and safe procedure that should be included in the armamentarium of urologists performing neuromodulation surgery in cases of intestinal perforation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Karapanos, Leonidas UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Kokx, Ruud UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmautz, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-313620
DOI:	10.5152/tud.2020.20320
Journal or Publication Title:	Turk. J. Urol.
Volume:	46
Number:	6
Page Range:	S. 492 - 496
Date:	2020
Publisher:	AVES
Place of Publication:	SISLI
ISSN:	2149-3057
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SACRAL NERVE-STIMULATION; FECAL INCONTINENCE Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31362