Ventriculoperitoneal shunt infections after bladder surgery: is mechanical bowel preparation necessary?

PURPOSE: We investigated whether children with a ventriculoperitoneal shunt who undergo mechanical bowel preparation before bladder reconstruction with bowel have a lower rate of infection than children who do not undergo preoperative bowel preparation.

MATERIALS AND METHODS: We performed an institutional review board approved, retrospective chart review of the incidence of ventriculoperitoneal shunt infections after bladder reconstruction using bowel and compared infection rates using Fisher's exact test. Mean ± SD followup was 2.9 ± 2.3 years.

RESULTS: Between 2003 and 2009, 31 patients with a ventriculoperitoneal shunt underwent bladder reconstruction using bowel, of whom 19 (61%) and 12 (39%) did and did not undergo mechanical bowel preparation, respectively. There was no significant difference in gender or age at surgery between the 2 groups. Infection developed in 3 children (9.6%) within 2 months postoperatively, including 2 (10.5%) with and 1 (8.3%) without bowel preparation (2-tailed p = 1.0).

CONCLUSIONS: There was no significant difference in the shunt infection rate between patients with a ventriculoperitoneal shunt who did and did not undergo preoperative bowel preparation. Our results add to the current literature suggesting that bowel preparation is unnecessary even in patients with a ventriculoperitoneal shunt.