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Sacral Neuromodulation in Children

  • Neurogenic Bladder (CR Powell, Section Editor)
  • Published:
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Abstract

Sacral neuromodulation (SNM) has emerged as a treatment option for refractory lower urinary tract and bowel dysfunction in children. SNM is typically reserved for a select population of children who have failed an extended period of behavioral modification, biofeedback, and pharmacologic therapy. The surgical techniques for SNM in children are analogous to those in adults and include both one- and two-stage procedures as well as a peripheral nerve evaluation with the InterStim® system (Medtronic, Minneapolis, MN). Most studies have observed not only an improvement in symptoms and quality of life in children undergoing SNM for non-neurogenic and neurogenic lower urinary tract dysfunction but also a much higher reoperative rate than in adults. Further high-quality research is necessary to corroborate the results of earlier studies and to better define the indications for SNM in children.

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References

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  1. Zhang F, Zhao S, Shen B, Wang J, Nelson DE, Roppolo JR, et al. Neural pathways involved in sacral neuromodulation of reflex bladder activity in cats. Am J Physiol Ren Physiol. 2013;304:F710–7.

    Article  CAS  Google Scholar 

  2. Hoebeke P, Bower W, Combs A, de Jong T, Yang S. Diagnostic evaluation of children with daytime incontinence. J Urol. 2010;183:699–703.

    Article  CAS  PubMed  Google Scholar 

  3. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society. J Urol. 2014;191:1863–65.e13.

    Article  PubMed  Google Scholar 

  4. Rawashdeh YF, Austin P, Siggaard C, Bauer SB, Franco I, de Jong TP, et al. International Children’s Continence Society’s recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children. Neurourol Urodyn. 2012;31:615–20.

    Article  CAS  PubMed  Google Scholar 

  5. Gamé X, Mouracade P, Chartier-Kastler E, Viehweger E, Moog R, Amarenco G, et al. Botulinum toxin-A (Botox) intradetrusor injections in children with neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic literature review. J Pediatr Urol. 2009;5:156–64.

    Article  PubMed  Google Scholar 

  6. Chase J, Austin P, Hoebeke P, McKenna P. The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children’s Continence Society. J Urol. 2010;183:1296–302.

    Article  PubMed  Google Scholar 

  7. Hassouna T, Gleason JM, Lorenzo AJ. Botulinum toxin A’s expanding role in the management of pediatric lower urinary tract dysfunction. Curr Urol Rep. 2014;15:426.

    Article  PubMed  Google Scholar 

  8. De Gennaro M, Capitanucci ML, Mosiello G, Zaccara A. Current state of nerve stimulation technique for lower urinary tract dysfunction in children. J Urol. 2011;185:1571–7.

    Article  PubMed  Google Scholar 

  9. Guys JM, Haddad M, Planche D, Torre M, Louis-Borrione C, Breaud J. Sacral neuromodulation for neurogenic bladder dysfunction in children. J Urol. 2004;172:1673–6. This is only 1 of 2 prospective randomized controlled trials, investigating the use of SNM in children with neurogenic LUTD.

    Article  CAS  PubMed  Google Scholar 

  10. Humphreys MR, Vandersteen DR, Slezak JM, Hollatz P, Smith CA, Smith JE, et al. Preliminary results of sacral neuromodulation in 23 children. J Urol. 2006;176:2227–31.

    Article  PubMed  Google Scholar 

  11. Roth TJ, Vandersteen DR, Hollatz P, Inman BA, Reinberg YE. Sacral neuromodulation for the dysfunctional elimination syndrome: a single center experience with 20 children. J Urol. 2008;180:306–11.

    Article  PubMed  Google Scholar 

  12. Haddad M, Besson R, Aubert D, Ravasse P, Lemelle J, El Ghoneimi A, et al. Sacral neuromodulation in children with urinary and fecal incontinence: a multicenter, open label, randomized, crossover study. J Urol. 2010;184:696–701. This is only 1 of 2 prospective randomized controlled trials, investigating the use of SNM in children with neurogenic LUTD.

    Article  CAS  PubMed  Google Scholar 

  13. Groen LA, Hoebeke P, Loret N, Van Praet C, Van Laecke E, Ann R, et al. Sacral neuromodulation with an implantable pulse generator in children with lower urinary tract symptoms: 15-year experience. J Urol. 2012;188:1313–7.

    Article  PubMed  Google Scholar 

  14. Stephany HA, Juliano TM, Clayton DB, Tanaka ST, Thomas JC, Adams MC, et al. Prospective evaluation of sacral nerve modulation in children with validated questionnaires. J Urol. 2013;190:1516–22.

    Article  PubMed  Google Scholar 

  15. Dwyer ME, Vandersteen DR, Hollatz P, Reinberg YE. Sacral neuromodulation for the dysfunctional elimination syndrome: a 10-year single-center experience with 105 consecutive children. Urology. 2014;84:911–7. This is the largest series of children undergoing SNM due to LUTD.

    Article  PubMed  Google Scholar 

  16. Medtronic Sacral Neuromodulation System Information for Prescribers. Medtronic, Inc. 2012. http://professional.medtronic.com/pt/uro/snm/prod/index.htm. Accessed 31 Jan 2015.

  17. McGee SM, Routh JC, Granberg CF, Roth TJ, Hollatz P, Vandersteen DR, et al. Sacral neuromodulation in children with dysfunctional elimination syndrome: description of incisionless first stage and second stage without fluoroscopy. Urology. 2009;73:641–4.

    Article  PubMed  Google Scholar 

  18. Fox JA, Reinberg YE. Incontinence. Pediatric sacral neuromodulation for refractory incontinence. Nat Rev Urol. 2010;7:482–3.

    Article  PubMed  Google Scholar 

  19. van Wunnik BP, Peeters B, Govaert B, Nieman FH, Benninga MA, Baeten CG. Sacral neuromodulation therapy: a promising treatment for adolescents with refractory functional constipation. Dis Colon Rectum. 2012;55:278–85.

    Article  PubMed  Google Scholar 

  20. Clark C, Ngo T, Comiter CV, Anderson R, Kennedy W. Sacral nerve stimulator revision due to somatic growth. J Urol. 2001;186:1576–80.

    Article  Google Scholar 

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No authors have any conflicts of interest to disclose.

Human and Animals Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Pediatric Urology at Riley Hospital for Children at IU Health, Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN, 46202, USA

    Andrew C. Strine, Alison C. Keenan, Shelly King & Benjamin M. Whittam

Authors
  1. Andrew C. Strine
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  2. Alison C. Keenan
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  3. Shelly King
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  4. Benjamin M. Whittam
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Corresponding author

Correspondence to Benjamin M. Whittam.

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This article is part of the Topical Collection on Neurogenic Bladder

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Strine, A.C., Keenan, A.C., King, S. et al. Sacral Neuromodulation in Children. Curr Bladder Dysfunct Rep 10, 332–337 (2015). https://doi.org/10.1007/s11884-015-0322-7

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  • DOI: https://doi.org/10.1007/s11884-015-0322-7

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