Case Report: Extrusion of a Sacral Nerve Implant Due to Engaging in Heavy Labor
Yu-Sun Guo1, Wen-Tong Ji1, Xiang-Ze Wang1,2
1Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, the Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
Abstract:
Sacral neuromodulation (SNM) is an effective treatment option for patients with an overactive bladder, non-obstructive retention, and fecal incontinence. Although the risk of device extrusion is relatively low, if it occurs, it can lead to severe complications and undermine clinical outcomes. Here, we report on a patient who experienced two episodes of device extrusion related to engaging in heavy labor. During treatments, we reimplanted the device successfully and highlight the importance of anti-infective therapy. Specifically, salvage management included urgent debridement with high-volume irrigation using 2 L of antibiotic solution, relocation of SNM device to a deeper subcutaneous plane (approximately 2 cm), and postoperative antibiotic therapy for 7 days. At the 7-month follow-up, the patient showed no evidence of recurrence. We then reviewed 9 cases related to the migration and extrusion of SNM implants, summarizing the clinical characteristics, possible triggers, and optimal treatment for clinicians when encountering similar situations.