Broken Sacral Neuromodulation Lead Migration Into the Sigmoid Colon: A Case Report

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.