Single-stage removal of three nonfunctioning sacral neuromodulation leads and reimplantation in a patient with chronic urinary retention: A case report

Sacral neuromodulation (SNM) is a well-established therapy for non-obstructive urinary retention and overactive bladder. However, long-term complications and optimal management of nonfunctioning tined leads remain underreported. We present the case of a 54-year-old woman with a history of neurogenic bladder secondary to encephalomyelitis. Over a 10-year period, she underwent three SNM lead implantations (S3/S4 bilaterally) at different institutions, with progressive loss of therapeutic benefit and development of pelvic and lumbar pain, sensory deficits, and lower limb myoclonus. Imaging confirmed lead integrity, but clinical symptoms persisted. In a single-stage procedure, all three previous leads were removed, and a new tined lead was implanted at the left S3 foramen and connected to a new InterStim II generator. Postoperative results were excellent, with resolution of neuropathic symptoms and restoration of spontaneous voiding. The patient remained symptom-free at 12-month follow-up. This case supports the feasibility and efficacy of single-stage explantation of multiple SNM leads and reimplantation in patients with chronic SNM-related complications and device failure. Early consideration of simultaneous lead removal and reimplantation may prevent prolonged morbidity.