Shunt infection and malfunction after augmentation cystoplasty

E. B. Yerkes, R. C. Rink, M. P. Cain, T. G. Luerssen, A. J. Casale

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: Maintenance of a sterile intraperitoneal environment is critical in patients with ventriculoperitoneal shunts. Recent series have reported a broad discrepancy in the rate of shunt infection (0% to 20%) following augmentation cystoplasty. The need for distal shunt revision has not been well defined. We report the incidence of shunt infection and revision at our institution after bladder augmentation. Materials and Methods: We retrospectively reviewed the records of all patients with myelodysplasia and a ventriculoperitoneal shunt who underwent augmentation cystoplasty since August 1990. All patients included in the study had a minimum of 12 months of followup. Results: A total of 55 patients with a ventriculoperitoneal shunt secondary to myelodysplasia required augmentation cystoplasty for management of a neuropathic bladder. Standard perioperative intravenous and oral antibiotic preparation, mechanical bowel preparation and intraoperative shunt isolation were used. Mean postoperative followup was 60.4 months (range 12 to 111). One patient presented with an extruded peritoneal shunt tip and positive cultures from cerebrospinal fluid and urine. Bladder perforation occurred in 2 patients and the shunt was empirically externalized. Revision was required for 5 (9%) distal shunt obstructions, including 1 cerebrospinal fluid pseudocyst. Conclusions: The incidence of shunt infection after augmentation cystoplasty is low (less than 2% in this large series), and presence of a ventriculoperitoneal shunt should not preclude bladder augmentation. Meticulous perioperative and intraoperative preparation contributes to the low rate of adverse events. Although the rate of distal revision after augmentation is significant, it does not exceed the reported distal failure rate for ventriculoperitoneal shunts in children without a history of urological surgery.

Original languageEnglish
Pages (from-to)2262-2264
Number of pages3
JournalJournal of Urology
Volume165
Issue number6 II SUPPL.
StatePublished - 2001

Fingerprint

Ventriculoperitoneal Shunt
Infection
Urinary Bladder
Cerebrospinal Fluid
Neurogenic Urinary Bladder
Incidence
Maintenance
Urine
Anti-Bacterial Agents

Keywords

  • Bladder
  • Meningomyelocele
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Urology

Cite this

Yerkes, E. B., Rink, R. C., Cain, M. P., Luerssen, T. G., & Casale, A. J. (2001). Shunt infection and malfunction after augmentation cystoplasty. Journal of Urology, 165(6 II SUPPL.), 2262-2264.

Shunt infection and malfunction after augmentation cystoplasty. / Yerkes, E. B.; Rink, R. C.; Cain, M. P.; Luerssen, T. G.; Casale, A. J.

In: Journal of Urology, Vol. 165, No. 6 II SUPPL., 2001, p. 2262-2264.

Research output: Contribution to journalArticle

Yerkes, EB, Rink, RC, Cain, MP, Luerssen, TG & Casale, AJ 2001, 'Shunt infection and malfunction after augmentation cystoplasty', Journal of Urology, vol. 165, no. 6 II SUPPL., pp. 2262-2264.
Yerkes EB, Rink RC, Cain MP, Luerssen TG, Casale AJ. Shunt infection and malfunction after augmentation cystoplasty. Journal of Urology. 2001;165(6 II SUPPL.):2262-2264.
Yerkes, E. B. ; Rink, R. C. ; Cain, M. P. ; Luerssen, T. G. ; Casale, A. J. / Shunt infection and malfunction after augmentation cystoplasty. In: Journal of Urology. 2001 ; Vol. 165, No. 6 II SUPPL. pp. 2262-2264.
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