Abstract
Computed tomography (CT)-guided lead placement for sacral neuromodulation was used in a patient with arthritis and narrow S3 foramina. Bilateral S3 foramina were localized and guide needles were placed with CT guidance. Lead placement was further modified by placement of a tined, quadripolar lead through a dilated S3 tract without initial somatosensory testing. The lead was then interrogated to assess placement and to differentiate superiority of response between two leads. The patient has had greater than 50 % improvement in urinary symptoms by voiding diary. Using CT guidance, satisfactory localization of bilateral S3 foramina may be achieved where prior attempts with conventional fluoroscopy have failed.
References
Chai TC, Mamo GJ (2001) Modified techniques of S3 foramen localization and lead implantation in S3 neuromodulation. Urology 58:786–790
Amoroso L, Pelliccioni G, Ghiselli R et al (2005) Sacral-neuromodulation CT-guided. Radiol Med 109:421–429
Blandon RE, Gebhart JB, Lightner DJ et al (2008) Re-operation rates after permanent sacral nerve stimulation for refractory voiding dysfunction in women. BJU Int 101:1119–1123
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chung, C.P., Neese, P.A., Le, H.K. et al. Computed tomography-guided S3 lead placement for sacral neuromodulation. Int Urogynecol J 24, 349–351 (2013). https://doi.org/10.1007/s00192-012-1816-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-012-1816-x