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Updated: Mar 1, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
A Rare Case of Repeated Migration and Transurethral Extrusion of Ventriculoperitoneal Shunt
Asra Al Fauzi1, Wahjoe Djatisoesanto2, Joni Wahyuhadi1
1Department of Neurosurgery, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia.
Abstract:
Bladder migration and transurethral extrusion is an extremely rare complication of ventriculoperitoneal (VP) shunt. Only eight cases have been reported in the English literature since 1995. We report a case of a 4-year-old boy with cerebral palsy, hydrocephalus, and VP shunted on both sides who presented with a protruded distal VP shunt from his urethral orifice. The patient was reported for having previous shunt extrusion through the anus. The patient was treated on by a multidisciplinary approach, involving a neurosurgeon and urologist. Shunt removal with simple procedure was smoothly achieved without morbidities. He was discharged home in satisfactory condition.
Insights
Ventriculoperitoneal shunt migration to the bladder and urethra is exceptionally rare. This case highlights a unique instance of distal shunt extrusion through the urethral orifice in a pediatric patient, successfully managed surgically.
Area of Science:
- Pediatric Neurosurgery
- Urology
- Medical Device Complications
Background:
- Ventriculoperitoneal (VP) shunts are crucial for managing hydrocephalus.
- Shunt migration, particularly bladder and transurethral extrusion, represents an extremely rare but serious complication.
- Previous literature reports only eight cases of VP shunt transurethral extrusion since 1995.
Observation:
- A 4-year-old boy with cerebral palsy and hydrocephalus presented with a distal VP shunt protruding from his urethral orifice.
- This patient had a history of prior shunt extrusion through the anus.
- The case involved bilateral VP shunts.
Findings:
- The distal VP shunt successfully migrated and extruded through the urethral orifice.
- A multidisciplinary team, including neurosurgery and urology, managed the case.
- Surgical removal of the extruded shunt was performed smoothly and without complications.
Implications:
- This case expands the understanding of rare VP shunt migration pathways.
- It underscores the importance of a multidisciplinary approach in managing complex shunt complications.
- Prompt surgical intervention is effective in resolving distal shunt extrusion and ensuring patient recovery.
