title: Buttock placement of the implantable pulse generator: a new implantation technique for sacral neuromodulation--a multicenter study.
abstract: OBJECTIVE
  In the standard operation procedure for sacral neuromodulation, the implantable pulse generator (IPG) is implanted in a subcutaneous pocket at the lower part of the anterior abdominal wall. This procedure requires a long operation time and three incisions. With the IPG in the abdominal wall, some patients complain of displacement or pain at the IPG site postoperatively. By modifying the technique of placement of the IPG, these disadvantages are overcome.
  
  
  METHODS
  Between August 1999 and July 2000, 39 patients underwent a buttock implant of the IPG. In 2 of these patients the position of the IPG was changed from abdominal region to the buttock. During follow-up, complications concerning the operation and location of the IPG were compared to the published literature.
  
  
  RESULTS
  Operation time is reduced in all patients by approximately 1 h. No repositioning of the patient is required during surgery. Only a short subcutaneous tunnel is required to connect the lead to the IPG. Pain at the level of the IPG was noted in 10% of the patients, which needed no further treatment. No infections were seen and the IPG did not displace postoperatively.
  
  
  CONCLUSIONS
  Buttock placement of the IPG in sacral nerve stimulation leads to shorter operation time; only two incisions are needed instead of three and a shorter subcutaneous tunnel is needed. Using this technique there are less complications and a lower re-operation rate.
authors.affiliation: Department of Urology, University Hospital, Maastricht, The Netherlands.
authors.forename: W A
authors.initials: WA
authors.lastname: Scheepens
authors.forename: E H
authors.initials: EH
authors.lastname: Weil
authors.forename: G A
authors.initials: GA
authors.lastname: van Koeveringe
authors.forename: D
authors.initials: D
authors.lastname: Rohrmann
authors.forename: H E
authors.initials: HE
authors.lastname: Hedlund
authors.forename: B
authors.initials: B
authors.lastname: Schurch
authors.forename: E
authors.initials: E
authors.lastname: Ostardo
authors.forename: M
authors.initials: M
authors.lastname: Pastorello
authors.forename: C
authors.initials: C
authors.lastname: Ratto
authors.forename: J
authors.initials: J
authors.lastname: Nordling
authors.forename: P E
authors.initials: PE
authors.lastname: van Kerrebroeck
mesh_terms: D000328:Adult; D000368:Aged; D002081:Buttocks / Q000601:surgery; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy*; D016055:Urinary Retention / Q000628:therapy*