Sixty patients underwent standard placement of the IPG while fifteen had abdominal placement. Nearly all of these abdominal placements were due to being wheelchair-dependent or lacking gluteal fat. No patients in the abdominal group underwent revision surgeries due to pain. While the standard and abdominal groups did vary at baseline, there was no significant difference in operative duration, infection rate, or time from implantation to revision between groups.
In terms of technique, the Interstim I device with an option for the 25cm extender has been phased out. When the battery expires, it may be necessary to revise abdominally placed IPGs to the standard location if the 45cm lead with the Interstim II device does not have adequate length to reach the abdomen, tension-free, in all patients. In the future, issues with sitting or lying on the device may be less of a problem with the use of smaller devices. However, data from studies like this may be needed to demonstrate to device companies that providing extenders in the future can be beneficial in select patients.
Adarsh Manjunath, MD, Resident Physician, Department of Urology, Northwestern University, Chicago, Illinois, Keeter MK, and Stephanie J. Kielb, MD, Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois and Kimberly Koloms, Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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