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Technique for removal of symptomatic bone anchors placed during stress incontinence surgery
John T Stoffel1, Seung-June Oh, Edward J McGuire
1Department of Urology, Lahey Clinic, Burlington, Massachusetts 01805, USA. stoffelj7@yahoo.com
Introduction:
To present an uncomplicated, reliable technique for bone anchor removal in patients with anchor-related infections or chronic pain.
Technical Considerations:
We removed 17 anchors from 9 patients between 1999 and 2004. The surgical technique used fluoroscopy for localization of the anchors and an orthopedic broken screw removal instrument for resection of the anchor and surrounding bone. Nine patients with bone anchors had been symptomatic with chronic pain and/or wound drainage for a mean of 23.7 months before surgery. After removal, 10 anchors grew positive bacterial cultures. The most common organism was coagulase-negative Staphylococcus. During a mean follow-up period of 6.8 months after hardware removal, 8 of the 9 patients had symptomatic improvement.
Conclusions:
Fluoroscopic localization and en bloc resection with a broken screw removal instrument is an effective method of removing symptomatic bone anchors.