Trump Tyler, Mitchell Katharina, Werner Zachary, Duenas-Garcia Omar, Shapiro Robert, Zaslau Stanley
Department of Urology, West Virginia University, 1 Medical Center Drive, Morgantown, WV, 26506, USA.
Department of Obstetrics and Gynecology, West Virginia University, Morgantown, WV, USA.
Int Urogynecol J. 2023 Oct;34(10):2513-2517. doi: 10.1007/s00192-023-05570-w. Epub 2023 May 24.
Sacral neuromodulation (SNM) is a commonly performed procedure for various conditions. Infection rates range as high as 10% and often require operative explantation with resultant increased cost and morbidity. Pouches impregnated with antibiotic have been utilized in cardiovascular procedures with decreasing infectious complications. TYRX is an antibiotic pouch utilizing minocycline and rifampin manufactured by Medtronic. The objective of this study is to investigate the utility of antimicrobial pouches for patients undergoing SNM.
We retrospectively analyzed our patients undergoing SNM using an antimicrobial pouch and compared them with a historic cohort. Additional variables of interest included post-operative infection, diagnosis of diabetes, weight, and revision case or virgin implant.
A total of 170 cases were identified, ranging from March 2017 to November 2022. Overall infection rate was 2.9% with 0 in the antimicrobial pouch cohort (0%) versus 5 in the historic cohort (5.5%; p = 0.04). Groups were similar in terms of body habitus. The group receiving an antimicrobial pouch was noted to be older with a higher percentage of female patients. 85 patients received an antimicrobial pouch and 85 did not. Of the infections, 4 occurred in revision cases (6.9%) and 1 in a virgin implant (0.9%; p = 0.03). No difference was noted in infection rate with regard to a diagnosis of diabetes or body habitus.
The use of antimicrobial pouches in SNM is associated with a decreased rate of infectious complications. Revision cases displayed a higher rate of infectious complications.
骶神经调节术（SNM）是针对多种病症常用的手术。感染率高达10%，且常常需要手术取出装置，从而导致成本增加和发病率上升。在心血管手术中已使用含抗生素的囊袋，其感染并发症有所减少。TYRX是美敦力公司生产的一种含米诺环素和利福平的抗生素囊袋。本研究的目的是调查抗菌囊袋在接受SNM的患者中的效用。
我们回顾性分析了使用抗菌囊袋接受SNM的患者，并将他们与一个历史队列进行比较。其他感兴趣的变量包括术后感染、糖尿病诊断、体重以及翻修病例或初次植入。
共确定了170例病例，时间跨度为2017年3月至2022年11月。总体感染率为2.9%，抗菌囊袋队列中为0例（0%），而历史队列中有5例（5.5%；p = 0.04）。两组在身体形态方面相似。接受抗菌囊袋的组年龄较大，女性患者比例较高。85例患者接受了抗菌囊袋，85例未接受。在感染病例中，4例发生在翻修病例中（6.9%），1例发生在初次植入中（0.9%；p = 0.03）。在糖尿病诊断或身体形态方面，感染率没有差异。
在SNM中使用抗菌囊袋与感染并发症发生率降低相关。翻修病例显示出较高的感染并发症发生率。
