Okhunov Zhamshid, Farhan Bilal, Ahmed Ahmed, Pulford Christopher, Ghoniem Gamal
Department of Urology, University of California, Irvine, California, USA.
Can J Urol. 2017 Aug;24(4):8918-8920.
We aimed to introduce our technique describing the removal of a chronic implanted tined-lead in patients with a sacral neuromodulator implant.
We performed a retrospective review of patients who had chronic sacral neuromodulator (InterStim) implanted by a single surgeon from 2001 through 2015. This simple surgical technique was developed and successfully performed to remove the leads. Primary reasons for removal were elective due to poor symptoms control and failure to maintain response or lead migration. Patient demographics, indication for implantation, as well as installation and removal complications were recorded and analyzed.
Twenty-five patients were included [mean age: 60.4 years (32-86), 17 females]. Primary indications for sacral nerve stimulation were overactive bladder in 16 (64%), mixed incontinence in 6 (24%), urinary retention in 2 (8%), and interstitial cystitis 3 (12%). Mean implant duration was 24.2 (0.5-90) months. The existing tined lead was removed and replaced in 11 (44%) patients while the remaining 14 (56%) underwent complete removal of the unit without subsequent replacement. Successful lead removal without complications was achieved in 24 (96%) patients.
This minimally invasive technique is a simple, safe, and effective method of removing chronic implanted tined leads en bloc.
我们旨在介绍一种在植入骶神经调节装置的患者中移除慢性植入的带倒刺导线的技术。
我们对2001年至2015年间由同一位外科医生植入慢性骶神经调节装置（InterStim）的患者进行了回顾性研究。开发并成功实施了这种简单的手术技术来移除导线。移除的主要原因是因症状控制不佳、无法维持反应或导线移位而进行的择期手术。记录并分析了患者的人口统计学数据、植入指征以及植入和移除并发症。
纳入25例患者[平均年龄：60.4岁（32 - 86岁），17例女性]。骶神经刺激的主要指征为膀胱过度活动症16例（64%）、混合性尿失禁6例（24%）、尿潴留2例（8%）、间质性膀胱炎3例（12%）。平均植入时间为24.2（0.5 - 90）个月。11例（44%）患者移除并更换了现有的带倒刺导线，其余14例（56%）患者完全移除了装置且未进行后续更换。24例（96%）患者成功移除导线且无并发症。
这种微创技术是一种简单、安全且有效的整块移除慢性植入带倒刺导线的方法。
