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A broken sacral neuromodulation lead migrated to the colon, causing infection and fistula. Prompt removal via colonoscopy resolved the issue, highlighting potential complications of retained leads.

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Area of Science:

  • Urology
  • Gastroenterology
  • Medical Device Technology

Background:

  • Sacral neuromodulation (SNM) is a recognized treatment for urinary and fecal incontinence, and urinary retention.
  • SNM procedures are generally low-risk with infrequent complications.
  • Device explantation or revision is sometimes necessary for efficacy assessment or management.

Observation:

  • A 40-year-old woman experienced lead breakage during SNM device explantation, leaving a fragment in situ.
  • Four months post-explantation, the patient developed a wound infection at the lead site.
  • Imaging confirmed migration of the retained lead fragment into the sigmoid colon, forming a colocutaneous fistula.

Findings:

  • Retained sacral neuromodulation leads can migrate through the peritoneum into the gastrointestinal tract.
  • Lead migration can precipitate serious complications such as infection and fistulas.
  • Successful management involved colonoscopic removal of the lead fragment and subsequent fistula healing.

Implications:

  • Highlights the risk of lead fragment migration following SNM procedures.
  • Emphasizes the importance of complete device removal and careful surgical technique.
  • Demonstrates the efficacy of multidisciplinary management involving colorectal and gastroenterology specialists for retained lead complications.