Sacral Neuromodulation in a Patient with Wolff-Parkinson-White Syndrome: A Case Report

Sacral neuromodulation has gained widespread use for bladder overactivity, frequency, urgency, fecal incontinence, and nonobstructive urinary retention; hence, implantations of this device in patients with comorbid cardiac conduction diseases have increased. Theoretically, there are some concerns regarding the use of sacral neuromodulation implants in patients with Wolf-Parkinson-White syndrome and cardiac conduction diseases because of the risk of interference with electrical impulses. This study aimed to describe the safety of using sacral neuromodulation to treat nonobstructive urinary retention in patients with a cardiac conduction disease. We report a case in which sacral neuromodulation was performed to treat nonobstructive urinary retention in a 25-year-old woman with Wolf-Parkinson-White syndrome who was receiving antiarrhythmic medication. The patient underwent magnetic resonance imaging of the spine and urodynamic studies after presenting with urinary symptoms at a urology clinic. She was then diagnosed with nonobstructive urinary retention. She underwent two-staged InterStim therapy, which involved implanting a permanent tined lead through the S3 foramen in the first stage and an implantable pulse generator in the second stage. The patient responded well to the therapy, and the frequency of clean intermittent catheterization was reduced from 6 times a day to once daily with only 250 mL drained per day. The cardiology team recommended intraoperative cardiac monitoring and postoperative electrocardiogram monitoring. No interference was observed between the implantable pulse generator and the cardiac rhythm on electrocardiography. She experienced no exacerbation of her cardiac symptoms. Sacral neuromodulation in a patient with Wolf-Parkinson-White syndrome appears to have been safe. Further, prospective and randomized studies with larger study samples are required to investigate the safety of these implants in WPW patients.