Successful sacral nerve modulation despite migration of tined lead

Stefanie Dekkers, Roderick F Schmitz, Johannes TM van der Heyden, Coen IM Baeten

Abstract


Background: Sacral nerve modulation (SNM) is a minimally invasive treatment for chronic constipation or incontinence when conservative treatment is insufficient to provide relieve of symptoms.
Case description: A 74-year-old patient with an implanted sacral nerve lead is presented in this case report with a dislodged lead without an adverse change in her incontinence treatment. This phenomenon has never been described before and raises the debate on sacral lead positioning in sacral nerve stimulation.
Discussion: There are a lot of conflicting data regarding ideal lead positioning, such as S3 versus S2 or S4 implantation. The lead position in our case doesn’t correspond to previously described locations and pathways which corroborate the legitimacy of new developments in this area such as percutaneous tibial nerve stimulation, transcutaneous tibial nerve stimulation and transcutaneous abdominal electrical stimulation (TEN).
Conclusions: The implantation of SNM seems standardized but leaves voids in the technique where further research is needed to refine it.

Full Text:

PDF

References


Craggs M, McFarlan J. Neuromodulation of the lower urinary tract. Exp Physiol. 1999;84:149–60.

Hetzer F, Hahnloser D, Knoblauch Y, Al. E. New screening technique for sacral nerve stimulation under local aneasthesia. Tech Coloproctol. 2005;9:25–8.

Govaert B, Melenhorst J, van Gemert W, Baeten C. Can sensory and/or motor reactions during percutaneous nerve evaluation predict outcome of sacral nerve modulation? Dis Colon Rectum. 2009;52:1423–6.

Cohen B, Tunuguntla H, Gousse A. Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol. 2006;(175):2178–80.

Fall M, Lindström S. Electrical stimulation. A physiologic approach to the treatment of urinary incontinence. Urol Clin North Am. 1991;18:393–407.

Fowler C, Swinn M, Goodwin R, Al E. Studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated. J Urol. 2000;163:881–3.

Schmidt R, Senn E, Tanagho E. Functional evaluation of sacral nerve root integrity. Urology. 1990;35:388–92.

Melenhorst J, Koch S, Uludag O, Al. E. Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantations. Colorectal Dis 2007;9:725-30. Color Dis. 2007;9:725–30.

Edlund C, Hellström M, Peeker R, Fall M. First Scandinavian experience of electrical sacral nerve stimulation in the treatment of the overactive bladder. Scand J Urol Nephrol. 2000;34:366–76.

Van Kerrebroeck, EV Scheepens W, de Bie R, Weil E. European experience with bilateral sacral neuromodulation in patients with chronic lower urinary tract dysfunction. Urol Clin North Am. 2005;32:51–7.

Scheepens W, Van Koeveringe G, De Bie R, Weil E, Van Kerrebroeck P. Long-term efficacy and safety results of the two-stage implantation technique in sacral neuromodulation. BJU Int. 2002;90:840–5.

Matzel K, Stadelmaier U, Bittorf B, Hohenfellner M, Hohenberger W. Bilateral sacral spinal nerve stimulation for fecal incontinence after low anterior resection. Int J Color Dis. 2002;17:430–4.

Matzel K, Stadelmaier U, Hohenfellner M, Gall F. Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet. 1995;346:1124–7.

Gourcerol G, Gallas S, Michot F, Denis P, Leroi A. Sacral nerve stimulation in fecal incontinence: are there factors associated with success? Dis Colon Rectum. 2007;50:3–12.

Vaizey C, Kamm M, Roy A, Nicholls R. Double-blind crossover study of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum. 2000;43:298–302.

Duelund-Jakobsen J, Buntzen S, Lundby L, Laurberg S. Sacral nerve stimulation at subsensory threshold does not compromise treatment efficacy: results from a randomized, blinded crossover study. Ann Surg. 2013;(257):219–23.

Koch S, van Gemert W, Baeten C. Determination of therapeutic threshold in sacral nerve modulation for faecal incontinence. Br J Surg. 2005;92:83–7.

Dudding T, Parés D, Vaizey C, Kamm M. Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: a 10-year cohort analysis. Color Dis. 2008;10:249–56.

Clarke MCC, Chase JW, Gibb S, Hutson JM, Southwell BR. Improvement of quality of life in children with slow transit constipation after treatment with transcutaneous electrical stimulation. J Pediatr Surg. 2009;44(6):1268–72.

Chase J, Robertson VALJ, Southwell B, Hutson J, Gibb S. Pilot study using transcutaneous electrical stimulation ( interferential current ) to treat chronic treatment-resistant constipation and soiling in children. J Gastroenterol Hepatol. 2005;20:1054–61.

Van Wunnik BPW, Baeten CGMI, Southwell BR. Neuromodulation for constipation: sacral and transcutaneous stimulation. Best Pract Res Clin Gastroenterol. 2011;25(1):181–91.

Thin N, Taylor S, Bremner S, Emmanuel A, Hounsome N, Williams N, et al. Randomized clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence. Br J Surg. 2015;102(4):349–58.

Bouguen G, Ropert A, Lainé F, Pequin P, Morcet J, Bretagne J, et al. Effects of transcutaneous tibial nerve stimulation on anorectal physiology in fecal incontinence: a double-blind placebo-controlled cross-over evaluation. Neurogastroenterol Motil. 2014;26(2):247–54.




DOI: https://doi.org/10.5430/css.v2n2p54

Refbacks

  • There are currently no refbacks.


Case Studies in Surgery  ISSN 2377-7311(Print)  ISSN 2377-732X(Online)

Copyright © Sciedu Press

To make sure that you can receive messages from us, please add the 'sciedu.ca' and ‘sciedupress.com’ domains to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', please check your 'spam' or 'junk' folder.