Related Experiment Video
Updated: Jul 17, 2025
Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa
Published on: September 27, 2018
Microbial colonization of sacral nerve stimulators pseudo-capsule: A single institution experience
Mostafa M Mostafa1,2, Mohamed Kamel1, Ayman Mahdy1
1Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Purpose:
To 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 Methods:
A 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.
Results:
A 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%).
Conclusions:
PC 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.
Insights
Microbial colonization of the pseudo-capsule around sacral nerve stimulators (SNS) is uncommon during device revision or removal. Further research is needed to determine if positive cultures increase infection risk despite sterile techniques.
Area of Science:
- Urology
- Infectious Disease
- Biomaterials
Background:
- Sacral nerve stimulators (SNS) are used to treat various lower urinary tract dysfunctions.
- A pseudo-capsule (PC) can form around implanted SNS devices.
- The microbial colonization of this PC and its clinical significance are not well understood.
Purpose of the Study:
- To determine the incidence and types of microbial colonization of the PC around SNS devices.
- To evaluate the significance of surgical excision of the PC during SNS revision or removal.
Main Methods:
- Retrospective review of 31 patients undergoing SNS revision or removal between January 2018 and June 2021.
- Analysis of baseline demographics, PC microbial colonization rates, and incidence of SNS insertion site infections.
- Microbial cultures of the PC were performed.
Main Results:
- 31 patients (93.5% female) with a mean age of [age not specified] underwent SNS revision or removal.
- The most common indication for SNS was refractory overactive bladder (67.7%).
- Four patients (12.9%) had positive PC cultures: Coryneform bacillus (50%), Cutibacterium acnes (25%), and Pseudomonas aeruginosa (25%).
Conclusions:
- Pseudo-capsule colonization is infrequent at the time of sacral nerve stimulator explantation.
- The role of PC-positive cultures in increasing the risk of SNS device infections requires further investigation, even with strict sterile techniques.
