Microbial colonization of sacral nerve stimulators pseudo-capsule: A single institution experience

• Published in: Investigative and clinical urology Vol. 64; no. 5; pp. 495 - 500
• Main Authors: Mostafa, Mostafa M., Kamel, Mohamed, Mahdy, Ayman
• Format: Journal Article
• Language: English
• Published: The Korean Urological Association 01-09-2023; Korean Urological Association
• Subjects: capsules; electric stimulation; host microbial interactions; implantable neurostimulators; Original; sacrum
• ISSN: 2466-0493; 2466-054X
• DOI: 10.4111/icu.20230111

PURPOSETo evaluate the incidence and type of microbial colonization of the pseudo-capsule (PC) that forms around sacral nerve stimulators (SNS) and consequently the significance of surgical excision of this PC at time of SNS revision or removal. MATERIALS AND METHODSA cohort of 31 patients who underwent SNS revision or removal from January 2018 to June 2021 were retrospectively reviewed. The baseline demographics, rate and type of PC microbial colonization and development of SNS insertion site infection were reported. RESULTSA cohort of 31 patients who underwent "InterStim device (Medtronic)" revision or removal were included. The majority were females (93.5%). The most common indication for SNS insertion was refractory overactive bladder (67.7%). Nine patients (29.0%) underwent SNS revision due to malfunctional device, and 9 patients had SNS removal for the need of MRI procedures. Four patients (12.9%) had positive tissue culture growing Coryneform bacillus (50.0%), Cutibacterium acnes (25.0%) and Pseudomonas aeruginosa (25.0%). CONCLUSIONSPC colonization was uncommon at the time of SNS explant. However, more research is needed to better understand the role of PC-positive culture in increasing the risk of SNS device infections if strict adherence to sterile techniques is adopted.