Implant infection after two-stage sacral nerve stimulator placement

Abstract

To report our experience with implant infection after two-stage sacral nerve stimulator placement. We reviewed the records of all patients who underwent implantation with a sacral nerve stimulator for the management of refractory cases of urge urinary incontinence, urinary frequency, and non-obstructive urinary retention. Baseline demographic data, interval to the development of infection, and the organism cultured are reported. After stage II neurostimulator placement, 5 out of 37 (13.5%) women required device removal for culture positive wound infections. Patients returned an average of 147.4 days after device implantation with evidence of infection. Infection occurred a minimum of 33 days, a median of 76 days, and a maximum of 461 days after sacral nerve stimulator implantation. The most common pathogen cultured was Staphylococcus aureus. After device removal, all patients resolved their infections. Two patients underwent uncomplicated reimplantation in the contralateral buttock 14 and 16 days after stimulator removal. The risk of infection after tined lead pretest and neurostimulator placement may be higher than previously observed in older techniques.