Skip to main content
Top
Published in: International Urogynecology Journal 2/2010

01-12-2010

Current opinion: complications and troubleshooting of sacralneuromodulation

Author: Paul Pettit

Published in: International Urogynecology Journal | Special Issue 2/2010

Login to get access

Abstract

The complications of sacral neuromodulation have been minimized as technology has improved. The main surgical complication remains to be surgical site infection. We review evidence-based suggestions and procedure-specific techniques that reduce the infection rate to less than 2%. In the past, surgical revision was reported as high as 40%. The current revision rate at Mayo Clinic Florida is 10%. The most common reason for surgical revision is either battery end-of-life or loss of effectiveness. We review the best practices of the procedure and a systematic approach to troubleshoot loss of effectiveness.
Literature
1.
go back to reference Blandon RE, Gebhart JB, Lightner DJ, Klingele JC (2008) Re-operation rates after permanent sacral nerve stimulations for refractory voiding dysfunction in women. Mayo Found Med Educ Res 101:1119–1123 Blandon RE, Gebhart JB, Lightner DJ, Klingele JC (2008) Re-operation rates after permanent sacral nerve stimulations for refractory voiding dysfunction in women. Mayo Found Med Educ Res 101:1119–1123
2.
go back to reference Spinelli M, Sievert K (2008) Latest technologic and surgical developments in using InterStim™ therapy for sacral neuromodulation: impact on treatment success and safety. Eur Urol 54:1287–1296CrossRefPubMed Spinelli M, Sievert K (2008) Latest technologic and surgical developments in using InterStim™ therapy for sacral neuromodulation: impact on treatment success and safety. Eur Urol 54:1287–1296CrossRefPubMed
3.
go back to reference Starkman JS, Wolter CE, Scarpero HM et al (2007) Management of refractory urinary urge incontinence following urogynecologic surgery with sacral neuromodulation. Neurourol Urodyn 26:29CrossRefPubMed Starkman JS, Wolter CE, Scarpero HM et al (2007) Management of refractory urinary urge incontinence following urogynecologic surgery with sacral neuromodulation. Neurourol Urodyn 26:29CrossRefPubMed
4.
go back to reference Amundsen CL, Romero AA, Jamison MG, Webster GD (2005) Sacral neuromodulation for intractable urge incontinence: are there factors associated with cure. Urology 66(4):746–750CrossRefPubMed Amundsen CL, Romero AA, Jamison MG, Webster GD (2005) Sacral neuromodulation for intractable urge incontinence: are there factors associated with cure. Urology 66(4):746–750CrossRefPubMed
5.
go back to reference Guidelines for Prevention of Surgical Sites Infections (1999) National center for infectious diseases, centers for disease control and prevention, public health service. US Department of Health and Human Services Guidelines for Prevention of Surgical Sites Infections (1999) National center for infectious diseases, centers for disease control and prevention, public health service. US Department of Health and Human Services
6.
go back to reference Dale W, Bratzler PM, Houck PM (2004) Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 38(12):1706–1715CrossRef Dale W, Bratzler PM, Houck PM (2004) Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 38(12):1706–1715CrossRef
7.
go back to reference Chia TC, Mamo G (2001) Modified techniques of S3 foramen localization and lead implantation in S3 neuromodulation. Urology 58(5):786–790CrossRef Chia TC, Mamo G (2001) Modified techniques of S3 foramen localization and lead implantation in S3 neuromodulation. Urology 58(5):786–790CrossRef
8.
go back to reference Cohen BL, Hsgr T, Gousse A (2006) Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol 175:2178–2181CrossRefPubMed Cohen BL, Hsgr T, Gousse A (2006) Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol 175:2178–2181CrossRefPubMed
9.
go back to reference Chen H, Lamer TJ et al (2004) Contemporary management of neuropathic pain for the primary care physician. Mayo Clin Proc 79(12):1533–1545CrossRefPubMed Chen H, Lamer TJ et al (2004) Contemporary management of neuropathic pain for the primary care physician. Mayo Clin Proc 79(12):1533–1545CrossRefPubMed
10.
go back to reference Ubbink DT, Westerbos SJ, Evans D, Land L, Vermeulen H (2008). Topical negative pressure for treating chronic wounds. Cochrane database of systematic reviews (3):CD001898. doi:10.1002/14651858.CD001898.pub2. PMID 18646080 Ubbink DT, Westerbos SJ, Evans D, Land L, Vermeulen H (2008). Topical negative pressure for treating chronic wounds. Cochrane database of systematic reviews (3):CD001898. doi:10.​1002/​14651858.​CD001898.​pub2. PMID 18646080
11.
go back to reference Gaynor-Krupnick D, Dwyer NT, Rittenmeyer H, Kreder KJ (2006) Evaluation and management of malfunctioning sacral neuromodulation. Urology 67:246–249CrossRefPubMed Gaynor-Krupnick D, Dwyer NT, Rittenmeyer H, Kreder KJ (2006) Evaluation and management of malfunctioning sacral neuromodulation. Urology 67:246–249CrossRefPubMed
12.
go back to reference van Kerrebroeck PEV, van Voskuilen AC et al (2007) Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol 178:2029–2034CrossRefPubMed van Kerrebroeck PEV, van Voskuilen AC et al (2007) Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol 178:2029–2034CrossRefPubMed
Metadata
Title
Current opinion: complications and troubleshooting of sacralneuromodulation
Author
Paul Pettit
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue Special Issue 2/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1279-x

Other articles of this Special Issue 2/2010

International Urogynecology Journal 2/2010 Go to the issue