Any new clinical data, whether positive or negative, generated about a medical device should be published because health\nprofessionals should knowwhich devices do notwork, aswell as thosewhich do.We report three spinal cord injury patients inwhom\nurological implants failed to work. In the first, paraplegic, patient, a sacral anterior root stimulator failed to produce erection, and a\ndrug delivery system for intracavernosal administration of vasoactive drugs was therefore implanted; however, this implant never\nfunctioned (and, furthermore, such penile drug delivery systems to produce erection had effectively become obsolete following\nthe advent of phosphodiesterase type 5 inhibitors). Subsequently, the sacral anterior root stimulator developed a malfunction and\nthe patient therefore learned to perform self-catheterisation. In the second patient, also paraplegic, an artificial urinary sphincter\nwas implanted but the patient developed a postoperative sacral pressure sore. Eight months later, a suprapubic cystostomy was\nperformed as urethral catheterisation was very difficult. The pressure sore had not healed completely even after five years. In the\nthird case, a sacral anterior root stimulator was implanted in a tetraplegic patient in whom, after five years, a penile sheath could\nnot be fitted because of penile retraction. This patient was therefore established on urethral catheter drainage. Later, infection with\nStaphylococcus aureus around the receiver block necessitated its removal. In conclusion, spinal cord injury patients are at risk of\ndeveloping pressure sores, wound infections, malfunction of implants, and the inability to use implants because of age-related\nchanges, as well as running the risk of their implants becoming obsolete due to advances in medicine. Some surgical procedures\nsuch as dorsal rhizotomy are irreversible. Alternative treatments such as intermittent catheterisations may be less damaging than\nbladder stimulator in the long term.
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