title: Ventriculoperitoneal shunt infections after bladder surgery: is mechanical bowel preparation necessary?
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Children's Hospital, University of Colorado School of Medicine, Aurora, Colorado 80045, USA.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Casperson
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Fronczak
authors.forename: Georgette
authors.initials: G
authors.lastname: Siparsky
authors.forename: Colin
authors.initials: C
authors.lastname: O'Donnell
authors.forename: Mohan S
authors.initials: MS
authors.lastname: Gundeti
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Campbell
authors.forename: Duncan T
authors.initials: DT
authors.lastname: Wilcox
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D015994:Incidence; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D055815:Young Adult