Introduction: We aimed to evaluate the rate of microbial colonization of the pseudo-capsule that forms around sacral nerve stimulators (SNS) and, consequently, the significance of surgical excision of this pseudo-capsule at the time of SNS revision or removal.

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 of pseudo-capsule microbial colonization, and development of SNS insertion site clinical infection were reported.

Results: A cohort of 31 patients who underwent InterStim device (Medtronic, Minneapolis, MN) revision or removal were included. The majority were females (93.5%). The most common indication for SNS was refractory overactive bladder (OAB) (67.7%). Nine patients (29%) underwent SNS revision due to malfunctional device and nine had SNS removal for the need of magnetic resonance imaging procedures (29%). Four patients (12.9%) had positive tissue culture growing Coryneform bacillus (50%), Cutibacterium acnes (25%), and Pseudomonas aeruginosa (25%) (Table 1).                                                                                

Conclusions: Pseudo-capsule colonization was uncommon at the time of SNS revision; however, it remains unclear whether removal of pseudo-capsule will reduce the risk of infection or not.