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Prolonged percutaneous SNM testing does not cause infection-related explanation.
Bastian Amend1, Jens Bedke, Mahmoud Khalil
1Department of Urology, Eberhard Karls University Tuebingen, Tuebingen, Germany.
BJU International
|June 29, 2012
Summary
Prolonged sacral neuromodulation (SNM) testing with permanent electrodes did not increase infection risks, despite bacterial colonization. This extended evaluation period may improve long-term treatment success for pelvic-related dysfunctions.
Area of Science:
- Urology
- Neurology
- Medical Device Technology
Background:
- Sacral neuromodulation (SNM) is a recognized treatment for various pelvic dysfunctions.
- Current SNM evaluation typically involves temporary or permanent electrodes.
- Limited data exists on infection risks associated with prolonged testing using permanent electrodes.
Purpose of the Study:
- To assess the impact of extended Stage 1 SNM testing on bacterial colonization, infection rates, and treatment success.
- To investigate the safety and efficacy of prolonged SNM evaluation using definitive electrodes.
Main Methods:
- A prospective study of 21 patients undergoing SNM for at least one month.
- Microbiological analysis of electrode extension leads to detect bacterial colonization.
- Evaluation of treatment success based on a 70% minimum improvement criterion.
Main Results:
- The mean Stage 1 testing duration was 52.3 days.
- Bacterial colonization was observed in 42.9% of patients and 38.2% of leads.
- No infections or wound healing issues were noted in Stage 2 patients (mean follow-up 33.9 months), with a 94% success rate.
Conclusions:
- Prolonged SNM Stage 1 testing with permanent electrodes can enhance treatment efficacy without increasing infection-related explantation rates.
- Despite bacterial presence, extended testing appears safe and effective for evaluating pelvic-related dysfunctions.
- Close monitoring of SNM patients with diabetes or obesity is recommended.
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