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Case Reports
. 2024 Nov 27:58:102894.
doi: 10.1016/j.eucr.2024.102894. eCollection 2025 Jan.

A case of lead migration after sacral neuromodulation with erosion into the rectum

Bridget S Kastelberg  1 , Madeline C Donnelly  1 , George B Smallfield 3rd  2 , Stephen P Sharp  3 , Laura R Carucci  4 , Adam P Klausner  1
Affiliations
Case Reports

A case of lead migration after sacral neuromodulation with erosion into the rectum

Bridget S Kastelberg et al. Urol Case Rep. .

Abstract

We present a case of a 73-year-old female with medication refractory overactive bladder treated with the InterStim® sacral neuromodulation device. Five months post implantation she developed drainage over the lead site and rectal bleeding. Evaluation identified lead migration with rectal perforation requiring surgical removal of the battery and lead. Post removal, the patient returned to baseline urinary symptoms with the development of de novo fecal incontinence. This is the third reported case of sacral neuromodulation lead migration causing rectal perforation in the literature, and the only case managed with endoscopic closure of the rectal defect.

Keywords: Lead migration; Overactive bladder; Rectal perforation; Sacral nerve modulation.

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Figures

Fig. 1
Fig. 1
Fluoroscopic Confirmation of Lead Position. Intraoperative anterior-posterior (A) and lateral (B) fluoroscopic images of the pelvis showing the lead in good position in the S3 sacral foramen.
Fig. 2
Fig. 2
Flexible Sigmoidoscopy Images. Images taken during flexible sigmoidoscopy showing erosion of the tined lead (arrow) into the rectum.
Fig. 3
Fig. 3
Sacral CT with Contrast. Coronal (A) and Axial (B) sacral CT images with IV and oral contrast showing the tined lead (arrow) within the lumen of the rectum.
See this image and copyright information in PMC

References

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