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Patterns of tined lead migration in sacral nerve modulation.
Emmanuel Ezra1, A M Helene Siilin2, Milan Gulobovic3
1Department of Surgical Sciences, Uppsala University, Akademiska Sjukhuset, 75 185, Uppsala, Sweden. Emmanuel.Ezra@surgsci.uu.se.
International Journal of Colorectal Disease
|March 8, 2020
Summary
Forward migration of tined leads is common in sacral nerve modulation, often causing loss of efficacy. This study investigated lead migration patterns and confirmed this hypothesis, suggesting further research is needed.
Area of Science:
- Neuromodulation
- Biomedical Engineering
- Urology
Background:
- Lead migration is a frequent cause of reduced effectiveness in sacral nerve modulation.
- Tined leads are commonly used in sacral nerve modulation therapies.
Purpose of the Study:
- To systematically investigate the migration patterns of tined leads used in sacral nerve modulation.
- To test the hypothesis that tined lead configuration may promote forward migration.
Main Methods:
- Retrospective analysis of 25 patients with loss of efficacy after sacral nerve modulation using tined leads.
- Radiographic assessment of lead migration (percentage of electrode movement) relative to the sacral cortex.
Main Results:
- All studied patients exhibited some degree of lead migration (35% backward to 74% forward).
- Forward migration occurred in 64% of patients, while 36% experienced backward migration.
- Loss of efficacy was linked to perceived mechanical strain in 28% of cases, with 50% of these showing forward migration.
Conclusions:
- Forward migration of tined leads is a common occurrence associated with loss of efficacy in sacral nerve modulation.
- The study supports the hypothesis that tined lead design may contribute to forward migration.
- Further research is required to elucidate the relationship between migration direction/magnitude and efficacy loss.
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