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Microbiological tined-lead examination: does prolonged sacral neuromodulation testing induce infection?
Mirjam Huwyler1, Gustav Kiss, Fiona C Burkhard
1Department of Urology, University of Bern, Bern, Switzerland.
BJU International
|April 3, 2009
Summary
Prolonged sacral neuromodulation (SNM) testing for over 14 days showed infection rates similar to short-term testing. Most bacterial growth on leads did not cause clinical infection, suggesting safety for extended SNM evaluation.
Area of Science:
- Urology
- Neurology
- Infectious Disease
Background:
- Sacral neuromodulation (SNM) is a treatment for lower urinary tract dysfunction.
- Percutaneous passage of extension wires during SNM testing raises infection concerns.
Purpose of the Study:
- To assess the infection risk associated with prolonged SNM testing (>14 days).
Main Methods:
- Prospective evaluation of 20 patients undergoing prolonged SNM testing (>14 days) with tined-lead explantation.
- Microbiological examination of explanted leads.
- Clinical assessment of incision sites for infection (CDC criteria).
Main Results:
- Bacterial growth (Staphylococcus) detected in 20% of patients (19% of leads).
- Clinical infection signs observed in only 5% of patients at lead or gluteal sites.
- No clinical infection signs in 75% of patients with bacterial growth.
Conclusions:
- Prolonged SNM testing does not appear to significantly increase clinically relevant infection risk.
- Infection rates are comparable to standard short-term testing periods.
- Further randomized trials are warranted to confirm these findings.
