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Troubleshooting sacral neuromodulation issues.

Maude E Carmel1, Sandip P Vasavada, Howard B Goldman

  • 1Female Pelvic Medicine & Reconstructive Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. carmelm@ccf.org

Current Urology Reports
|August 8, 2012
PubMed
Summary
This summary is machine-generated.

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Sacral neuromodulation advancements have decreased revision rates, but infection and pain at the implantable pulse generator (IPG) site are common. Physicians must manage complications to avoid further surgical revision.

Area of Science:

  • Urology
  • Neurology
  • Biomedical Engineering

Background:

  • Sacral neuromodulation (SNM) use has significantly increased over the past decade.
  • Technological advancements, including tined leads and smaller implantable pulse generators (IPGs), have evolved SNM procedures.
  • These changes have impacted the frequency and nature of associated complications.

Purpose of the Study:

  • To analyze the evolving landscape of complications in sacral neuromodulation.
  • To compare complication rates and types in contemporary SNM series versus earlier data.
  • To provide guidance on managing SNM-related complications and suboptimal responses.

Main Methods:

  • Review of contemporary sacral neuromodulation series.
  • Analysis of complication data, including infection, pain, and lead integrity.

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  • Evaluation of management strategies for decreased clinical response and pain.

    • Main Results:

    • Revision and explantation rates have decreased compared to earlier SNM data.
    • Common complications now include infection, pain at the IPG site, and reduced clinical response.
    • Device interrogation is crucial for diagnosing system integrity issues.

    Conclusions:

    • Modern SNM techniques have reduced overall revision rates.
    • Infection and IPG site pain are primary concerns requiring specific management protocols.
    • Physician awareness and troubleshooting skills are key to optimizing patient outcomes and minimizing surgical revisions.