Perforation of the colon with or without transanal extrusion of the distal ventriculoperitoneal shunt (VPS) catheter is a well-known but a serious complication after VPS insertion done for the treatment of hydrocephalus. The objectives were to review the demographics, clinical characteristics, operative procedures performed, postoperative complications, and the final outcome of the published cases, relating to the transanal extrusion of the distal VPS shunt catheter. Electronic database search was performed to retrieve the published/available literature relating to the transanal extrusion of VPS catheter. The manuscripts relating to the above-mentioned complication were retrieved from 1966 to December 2020. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines are followed for this review. This review included 210 cases comprising 142 (67.6%) males and 68 (32.3%) females. In two-third (n = 141) of the cases, the indication for the initial VPS insertion was the congenital hydrocephalus. In 60% of the cases, the initial VPS insertion was done during infancy. In 70% of the cases, the interval from VPS insertion to the diagnosis of transanal extrusion of the distal VPS catheter was within 12 months. Transanal extrusion of the distal VPS catheter was the chief complaint. In two-third of the cases, it was asymptomatic transanal extrusion of distal VPS catheter. In remaining one-third of the cases, it was symptomatic transanal extrusion of the distal VPS catheter, and they had either symptoms relating to the central nervous system or gastrointestinal tract. Three-fourth of the cases were managed by the removal of the entire or the distal VPS catheter with or without external ventricular drainage (EVD). Fifty percent of the above-mentioned complication was managed by doing percutaneous surgical procedures, and another one-third of them were managed by doing laparotomy. Complications were also evident in 16 (7.6%) of the cases during the postoperative period. This review revealed only 6 (2.8%) deaths. Transanal extrusion of the distal VPS catheter occurred across all the age groups. Eighty percent of the complications occurred in children below the age of 10 years. Three-fourth of the cases were managed by the removal of the entire or distal VPS catheter with or without EVD. In three-fourth of the cases, repair of the perforated bowel/colon was not done and that healed spontaneously after the removal of the extruded VPS catheter.

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Ventriculoperitoneal shunt (VPS) insertion is the most widely performed surgical procedure for the treatment of hydrocephalus across all age groups but is associated with several complications. The objectives of the present review were to review the demographics, clinical characteristics, operative procedures executed, postoperative major complications, and outcome of the cases published on the management of migration of the distal VPS catheter into the urinary bladder with or without per-urethral extrusion. PubMed, Medline, PubMed Central, Embase, ResearchGate, and Google Scholar database online search was performed to retrieve the published/available literature relating to the above-mentioned complication. Literature/Case reports were retrieved from the year 1974 to June 30, 2020, and those were available in the English language. Thirty-seven cases were included for review, and included n = 20 (54.05%) male, n = 15 (40.54%) female and gender details were not available for n = 2 (5.4%) of the cases. The mean age of the cases at the time of diagnosis of the above complication was 15.27 years. The mean interval from the VPS insertion to the diagnosis of the complication for the entire case was 4.7 years and ranged from 1 day to 26 years. Surgical procedures were performed for the management and were in order of frequency as; (a) removal of entire VPS catheter n = 20, (b) removal of distal VPS catheter n = 10, (c) removal/relocation of distal VPS catheter n = 6, and (d) details not available n = 1. Migration of the distal VPS catheter into the urinary bladder with or without per-urethral extrusion occurred across all the age groups. Seventy percent of the cases were children below the age of 15 years. In 50% of the cases, the complication was documented within 24 months after the VPS insertion. In two-third of the cases, repair of the urinary bladder perforation was not done and that healed spontaneously after the removal of the intra-vesical migrated VPS catheter.