A case of lead migration after sacral neuromodulation with erosion into the rectum

We present a case of a 73-year-old female with medication refractory overactive bladder treated with the InterStim® sacral neuromodulation device. Five months post implantation she developed drainage over the lead site and rectal bleeding. Evaluation identified lead migration with rectal perforation...

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Main Authors: Bridget S. Kastelberg, Madeline C. Donnelly, George B. Smallfield, III, Stephen P. Sharp, Laura R. Carucci, Adam P. Klausner
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Urology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214442024002481
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author Bridget S. Kastelberg
Madeline C. Donnelly
George B. Smallfield, III
Stephen P. Sharp
Laura R. Carucci
Adam P. Klausner
author_facet Bridget S. Kastelberg
Madeline C. Donnelly
George B. Smallfield, III
Stephen P. Sharp
Laura R. Carucci
Adam P. Klausner
author_sort Bridget S. Kastelberg
collection DOAJ
description We present a case of a 73-year-old female with medication refractory overactive bladder treated with the InterStim® sacral neuromodulation device. Five months post implantation she developed drainage over the lead site and rectal bleeding. Evaluation identified lead migration with rectal perforation requiring surgical removal of the battery and lead. Post removal, the patient returned to baseline urinary symptoms with the development of de novo fecal incontinence. This is the third reported case of sacral neuromodulation lead migration causing rectal perforation in the literature, and the only case managed with endoscopic closure of the rectal defect.
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spelling doaj-art-74b4b201ccef4014bd02865aa6e8ae8b2025-08-20T02:34:40ZengElsevierUrology Case Reports2214-44202025-01-015810289410.1016/j.eucr.2024.102894A case of lead migration after sacral neuromodulation with erosion into the rectumBridget S. Kastelberg0Madeline C. Donnelly1George B. Smallfield, III2Stephen P. Sharp3Laura R. Carucci4Adam P. Klausner5Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Corresponding author. Virginia Commonwealth University School of Medicine, Richmond, VA, USA.Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA, USADivision of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, VA, USADivision of Colorectal Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USADepartment of Radiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USADivision of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA, USAWe present a case of a 73-year-old female with medication refractory overactive bladder treated with the InterStim® sacral neuromodulation device. Five months post implantation she developed drainage over the lead site and rectal bleeding. Evaluation identified lead migration with rectal perforation requiring surgical removal of the battery and lead. Post removal, the patient returned to baseline urinary symptoms with the development of de novo fecal incontinence. This is the third reported case of sacral neuromodulation lead migration causing rectal perforation in the literature, and the only case managed with endoscopic closure of the rectal defect.http://www.sciencedirect.com/science/article/pii/S2214442024002481Sacral nerve modulationLead migrationOveractive bladderRectal perforation
spellingShingle Bridget S. Kastelberg
Madeline C. Donnelly
George B. Smallfield, III
Stephen P. Sharp
Laura R. Carucci
Adam P. Klausner
A case of lead migration after sacral neuromodulation with erosion into the rectum
Urology Case Reports
Sacral nerve modulation
Lead migration
Overactive bladder
Rectal perforation
title A case of lead migration after sacral neuromodulation with erosion into the rectum
title_full A case of lead migration after sacral neuromodulation with erosion into the rectum
title_fullStr A case of lead migration after sacral neuromodulation with erosion into the rectum
title_full_unstemmed A case of lead migration after sacral neuromodulation with erosion into the rectum
title_short A case of lead migration after sacral neuromodulation with erosion into the rectum
title_sort case of lead migration after sacral neuromodulation with erosion into the rectum
topic Sacral nerve modulation
Lead migration
Overactive bladder
Rectal perforation
url http://www.sciencedirect.com/science/article/pii/S2214442024002481
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