Open Access

ARTICLE

Surgical technique for removal of tined lead for InterStim

Zhamshid Okhunov¹, Bilal Farhan¹, Ahmed Ahmed^1,2, Christopher Pulford¹, Gamal Ghoniem¹

1 Department of Urology, University of California, Irvine, California, USA
2 Department of Urology, Aswan University, Egypt
Address correspondence to Dr. Gamal Ghoniem, Department of Urology, University of California, Irvine, 333 City Boulevard West, Suite 2100, Orange, CA92868 USA

Canadian Journal of Urology 2017, 24(4), 8918-8920.

Abstract

Introduction: We aimed to introduce our technique describing the removal of a chronic implanted tined-lead in patients with a sacral neuromodulator implant.
Materials and methods: 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.
Results: 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.
Conclusions: This minimally invasive technique is a simple, safe, and effective method of removing chronic implanted tined leads en bloc.

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