Furness P D, Franzoni D F, Decter R M
The Milton S. Hershey Medical Center of the Penn State Geisinger Health System, Department of Surgery, Section of Urology, Hershey, Pennsylvania 17033-0850, USA.
BJU Int. 1999 Jul;84(1):25-9. doi: 10.1046/j.1464-410x.1999.00124.x.
To review previous reports and our experience in assessing the risk of prosthetic infections in patients undergoing bladder augmentation simultaneously with artificial genitourinary sphincter (AGUS) implantation, and in patients with in situ ventriculoperitoneal (VP) shunts, implicated as a cause of shunt infection.
The literature was searched to identify the number of prosthetic infections (AGUS or VP shunt) reported in patients who have undergone bladder augmentation. Additionally, the records of 53 myelodysplastic patients at our institution who had undergone bladder augmentation were reviewed to determine the incidence of AGUS and/or VP shunt infections. An AGUS was placed in 17 of these patients, who were then divided into three groups based upon the timing of their AGUS placement relative to bladder augmentation. Of the 53 patients, 47 had an in situ VP shunt at the time of their augmentation. All patients were followed for at least 12 months.
The reported rate of AGUS infection at the time of simultaneous bladder augmentation was not significantly different from that when these procedures were staged. In the present series, the AGUS became infected in two patients (12%); one infection occurred in each of 10 patients undergoing simultaneous procedures (10%) and one developed in each of the seven patients undergoing staged procedures (14%). Although VP shunt infections have been reported after bladder augmentation, none of the present patients had a VP shunt infection after bladder augmentation.
These results suggest that bladder augmentation is not associated with an increased risk of prosthetic infection in patients undergoing simultaneous placement of an artificial sphincter or in those who have an in situ VP shunt.
回顾既往报道及我们自身的经验，评估在膀胱扩大术同期植入人工泌尿生殖括约肌（AGUS）的患者以及原位脑室腹腔（VP）分流术患者中发生假体感染的风险，后者被认为是分流感染的一个原因。
检索文献以确定在接受膀胱扩大术的患者中报道的假体感染（AGUS或VP分流）病例数。此外，回顾了我院53例接受膀胱扩大术的脊髓发育不良患者的记录，以确定AGUS和/或VP分流感染的发生率。其中17例患者植入了AGUS，然后根据AGUS植入时间与膀胱扩大术的先后关系将这些患者分为三组。53例患者中，47例在膀胱扩大术时已有原位VP分流。所有患者均随访至少12个月。
膀胱扩大术同期AGUS感染的报道发生率与分期手术时的发生率无显著差异。在本系列中，有2例患者（12%）的AGUS发生感染；同期手术的10例患者中有1例感染（10%），分期手术的7例患者中有1例感染（14%）。虽然有报道称膀胱扩大术后发生VP分流感染，但本研究中的患者在膀胱扩大术后均未发生VP分流感染。
这些结果表明，对于同期植入人工括约肌或有原位VP分流的患者，膀胱扩大术与假体感染风险增加无关。
