Sacral Neuromodulation and Twiddler's Syndrome

Twiddler's syndrome is the deliberate, inadvertent, or subconscious manipulation of an implantable generator within its subcutaneous pocket that can lead to malposition and fracture of the associated lead. The syndrome is well recognized in patients with pacemakers, implantable cardioverter defibrillators, deep brain stimulators, and more recently in intrathecal drug delivery devices. Here we present an instance of Twiddler's syndrome after sacral neuromodulation.