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Non-invasive massage technique to aid in removal of a tined sacral neuromodulation lead

Abstract

Introduction and hypothesis

Describe a novel technique for retrieval of the Interstim lead in part based on techniques used in massage therapy.

Methods

Retrospective review of patients (single surgeon) identified by CPT code 64585 over 10 years. Exclusion criteria included patients who (1) had explantation for active infection or (2) did not proceed with a stage 2 implant (in the event of a staged procedure). To effect removal, the surgeon applies a focused massage with firm deliberate pressure in deep circular motions to the insertion site and surrounding tissue. At the same time, gentle steady traction is applied to the lead (from the IPG pocket) by the surgeon.

Results

Sixty women were identified. Mean implant duration was 24 (6–60) months. There were three lead fractures at retrieval (5%). In all three occurrences, the inner conductor wire was removed despite leaving the tined fragment in place. The author did not perform a cutdown to retrieve the retained fragment. There were no peri- or postoperative complications.

Conclusions

Lead removal is safely accomplished in a matter of a few minutes with the presented technique without the need for a cutdown. Lead breakage was 5% and similar to more invasive techniques.

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References

  1. 1.

    Hijaz A, Vasavada SP, Daneshgari F, Frinjari H, Goldman H, Rackley R. Complications and troubleshooting of two-stage sacral neuromodulation therapy: a single-institution experience. Urology. 2006;68(3):533–7.

    Article  Google Scholar 

  2. 2.

    Pettit P. Current opinion: complications and troubleshooting of sacral neuromodulation. Int Urogynecol J. 2010;21(Suppl 2):S491.

    Article  Google Scholar 

  3. 3.

    Shannon MB, Gupta N, et al. Broken sacral neuromodulation lead migration into the sigmoid colon: a case report. Female Pelvic Med Reconstr Surg. 2018;24:e49–50.

    Article  Google Scholar 

  4. 4.

    Shih C, Miller JL, Fialkow M, et al. Reoperation after sacral neuromodulation therapy: a single-institution experience. Female Pelvic Med Reconstr Surg. 2013;19(3):175–8.

    Article  Google Scholar 

  5. 5.

    Spinelli M, Giardiello G, Gerber M, et al. New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience. J Urol. 2003;170:1905–7.

    Article  Google Scholar 

  6. 6.

    Medtronic Educational Brief. Unretrieved device fragments models 3093 and 3889 Interstim tined leads: tools for safe patient management. 2010. Minneapolis, MN.

  7. 7.

    Rueb JJ, Pizarro-Berdichevsky J, Goldman HB. 17 year single center retrospective review of rate, risk factors, and outcomes of lead breakage during sacral neuromodulation lead removal. J Urol 2020:101097JU0000000000000740.

  8. 8.

    Okhunov Z, Farhan B, Ahmed A, Pulford C, Ghoniem G. Surgical technique for removal of tined lead for InterStim. Can J Urol. 2017;24(4):8339–41.

    Google Scholar 

  9. 9.

    Sterling ME, Hartigan SM, Wein AJ, Smith AL. A standardized surgical technique for removal of the Interstim tined lead. Can J Urol. 2016 Oct;23(5):8471–5.

    PubMed  Google Scholar 

  10. 10.

    Faucheron JL, Herault MC. Life threatening haemorrhage after electrode removal: a severe complication following sacral nerve stimulation procedure for the treatment of faecal incontinence. Color Dis. 2012 Mar;14(3):e133.

    Article  Google Scholar 

  11. 11.

    Shin TM, Bordeaux JS. The role of massage in scar management: a literature review. Dermatol Surg. 2012 Mar;38(3):414–23.

    CAS  Article  Google Scholar 

  12. 12.

    Chamberlain GJ. Cyriax’s friction massage: a review. J Orthop Sports Phys Ther. 1982;4(1):16–22.

    CAS  Article  Google Scholar 

Download references

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Authors

Corresponding author

Correspondence to Ted M. Roth.

Ethics declarations

The author is a preceptor for Medtronic. The author is the sole contributor, and the work is not being presented/published elsewhere. The author performed the surgery, performed the retrospective review, and made all decisions regarding what data to abstract and present.

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None.

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Cite this article

Roth, T.M. Non-invasive massage technique to aid in removal of a tined sacral neuromodulation lead. Int Urogynecol J 32, 661–663 (2021). https://doi.org/10.1007/s00192-020-04539-3

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Keywords

  • Removal
  • Tined lead
  • InterStim
  • Sacral neuromodulation implant